本文選題：右美托咪定 + 羅哌卡因　； 參考：《中國新藥與臨床雜志》2017年02期

【摘要】：目的探討不同劑量右美托咪定混合羅哌卡因椎旁阻滯在開胸手術(shù)后的鎮(zhèn)痛效果。方法擇期全麻下行開胸肺癌根治術(shù)患者60例,隨機(jī)分為四組,每組15例。對照組誘導(dǎo)前椎旁給藥及術(shù)后鎮(zhèn)痛僅用羅哌卡因。右美托咪定劑量1組(Dex1組)、右美托咪定劑量2組(Dex2組)、右美托咪定劑量3組(Dex3組)誘導(dǎo)前椎旁給予0.35%羅哌卡因0.3 mL·kg~(-1)和右美托咪定1μg·kg~(-1),術(shù)后椎旁患者自控鎮(zhèn)痛(PCA)使用0.2%羅哌卡因和右美托咪定1、2、4μg·kg~(-1)。必要時(shí)靜脈給予地佐辛,維持術(shù)后48 h內(nèi)疼痛視覺模擬量表(VAS)評分≤3分。記錄各組阻滯后30 min,術(shù)后24 h,PCA結(jié)束后12、24 h的感覺阻滯節(jié)段數(shù);術(shù)后48 h內(nèi)PCA按壓次數(shù)及地佐辛用量。比較各組圍術(shù)期不良反應(yīng)發(fā)生情況。結(jié)果阻滯后30 min及術(shù)后24 h Dex1組、Dex2組、Dex3組感覺阻滯節(jié)段數(shù)多于對照組(P0.05);PCA結(jié)束后12、24 h,Dex2組與Dex3組感覺阻滯節(jié)段數(shù)多于Dex1組及對照組(P0.05)。Dex2組與Dex3組術(shù)后PCA按壓次數(shù)及地佐辛用量少于Dex1組及對照組(P0.05)。Dex2組與Dex3組各時(shí)點(diǎn)感覺阻滯節(jié)段數(shù)、術(shù)后PCA按壓次數(shù)及地佐辛用量無顯著差異(P0.05)。Dex3組心動過緩、嗜睡發(fā)生率高于其他三組(P0.05)。結(jié)論右美托咪定混合羅哌卡因椎旁阻滯用于開胸術(shù)后鎮(zhèn)痛可增加阻滯范圍,增強(qiáng)鎮(zhèn)痛效果,其中右美托咪定2μg·kg~(-1)混合羅哌卡因術(shù)后持續(xù)鎮(zhèn)痛,效果良好,不良反應(yīng)較少。
[Abstract]:Objective to investigate the analgesic effect of dexmetomidine combined with ropivacaine in paravertebral block after thoracotomy. Methods 60 patients with open chest lung cancer were randomly divided into four groups, 15 cases in each group. The patients in the control group were treated with ropivacaine only before paravertebral administration and postoperative analgesia. Dex1, Dex1, Dex2, Dex3, Dex2 and Dex3) were given paravertebral administration of 0.35% ropivacaine 0.3 mL kg-1) and dexmetomidine 1 渭 g kg-1 before induction. Ropivacaine 0.2% and dexmetomidine 4 渭 g 路kg ~ (-1) 路kg ~ (-1). When necessary, dizosin was given intravenously and the visual analogue pain scale (VAS) score was 鈮，

本文編號：1813240