[1]周 梅.右美托咪定静脉给药对罗哌卡因椎旁阻滞镇痛效果的影响[J].医学信息,2019,(19):139-142.[doi:10.3969/j.issn.1006-1959.2019.19.045]
 ZHOU Mei.Effect of Intravenous Administration of Dexmedetomidine on Analgesic Effect of Ropivacaine Paraspinal Block[J].Medical Information,2019,(19):139-142.[doi:10.3969/j.issn.1006-1959.2019.19.045]
点击复制

右美托咪定静脉给药对罗哌卡因椎旁阻滞镇痛效果的影响()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
期数:
2019年19期
页码:
139-142
栏目:
药物与临床
出版日期:
2019-10-01

文章信息/Info

Title:
Effect of Intravenous Administration of Dexmedetomidine on Analgesic Effect of Ropivacaine Paraspinal Block
文章编号:
1006-1959(2019)19-0139-04
作者:
周 梅
(成都中医药大学附属医院麻醉科,四川 成都 610072)
Author(s):
ZHOU Mei
(Department of Anesthesiology,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,Sichuan,China)
关键词:
右美托咪定罗哌卡因超声引导胸椎旁神经阻滞多模式镇痛
Keywords:
DexmedetomidineRopivacaineUltrasound-guided thoracic paravertebral nerve block Multimodal analgesia
分类号:
R614.4
DOI:
10.3969/j.issn.1006-1959.2019.19.045
文献标志码:
A
摘要:
目的 观察右美托咪定(DEX)经静脉给药对罗哌卡因椎旁神经阻滞镇痛效果的影响。方法 选取2017年5月~2019年1月我院择期行胸腔镜手术患者90例,随机分为对照组、DEXIV组和DEXP组,各30例。对照组不使用DEX,DEXIV组为DEX静脉给药,DEXP组为DEX神经周围给药,比较三组患者进入复苏室即刻(PACU)、椎旁神经阻滞后6、12、24 h的VAS疼痛评分,病人自控静脉镇痛(PCIA)术后首次按压时间、累计按压次数、镇痛药物需求及不良反应发生情况。结果 三组PACU时刻VAS评分比较,差异无统计学差异(P>0.05);对照组术后6、12 h VAS评分高于DEXIV组和DEXP组,差异有统计学意义(P<0.05);DEXIV组与DEXP组术后6、12 h VAS评分比较,差异无统计学意义(P>0.05);三组术后24 h VAS评分比较,差异无统计学意义(P>0.05)。对照组PCIA首次自控按压时间早于DEXIV组与DEXP组,且累计按压次数高于DEXIV组与DEXP组,差异有统计学意义(P<0.05);DEXIV组与DEXP组首次按压时间、累计按压次数比较,差异无统计学意义(P>0.05)。三组额外镇痛药物需求比较,差异无统计学意义(P>0.05);DEXIV组仅有1例患者发生心动过缓,三组不良反应比较,差异无统计学意义(P>0.05)。结论 无论是经静脉还是神经周围给药DEX均能延长罗哌卡因单次胸椎旁神经阻滞的镇痛时间,减少镇痛药物消耗和不良反应发生几率。
Abstract:
Objective To observe the effect of intravenous administration of dexmedetomidine (DEX) on the analgesic effect of ropivacaine paraspinal nerve block.Methods 90 patients undergoing thoracoscopic surgery in our hospital from May 2017 to January 2019 were randomly divided into control group, DEXIV group and DEXP group, 30 cases each. DEX was not used in the control group, DEX was administered in the DEXIV group, and DEX was administered in the DEXP group. VAS pain was observed in the three groups of patients immediately after entering the resuscitation chamber (PACU) and paravertebral nerve block lag of 6, 12, and 24 h. Score, patient-controlled intravenous analgesia (PCIA), first press time, cumulative compressions, analgesic drug requirements, and adverse events.Results There were no significant differences in VAS scores between the three groups of PACU (P>0.05). The VAS scores of the control group at 6 and 12 h after operation were higher than those of DEXIV and DEXP,the difference was statistically significant (P<0.05); There was no significant difference in VAS scores between the DEXIV group and the DEXP group at 6 and 12 h after operation (P>0.05). There was no significant difference in VAS scores between the three groups after 24 h (P>0.05).The first self-controlled compression time of PCIA in the control group was earlier than that in the DEXIV group and the DEXP group, and the cumulative compression times were higher than those in the DEXIV group and the DEXP group,the difference was statistically significant (P<0.05). There was no significant difference in the first compression time and cumulative compression times between DEXIV group and DEXP group (P>0.05). There was no significant difference in the demand of the three groups of additional analgesic drugs (P>0.05). Only one patient in the DEXIV group had bradycardia. There were no significant differences between the three groups (P>0.05).Conclusion Both intravenous and peri-injection of DEX can prolong the analgesic time of ropivacaine single thoracic paravertebral nerve block and reduce the incidence of analgesic drug consumption and adverse reactions.

参考文献/References:

[1]Abdallah FW,Brull R.Facilitatory effects of perineural dexmedetomidine on neuraxial and peripheral nerve block:a systematic review and meta-analysis[J].British Journal of Anaesthesia,2013,110(6):915-925. [2]Eppstein AC,Sakamoto B.The novel use of different bupivacaine preparations with combined regional techniques for postoperative pain management in non-opioid-based laparoscopic inguinal herniorrhaphy[J].Journal of Clinical Anesthesia,2016(34):403-406. [3]Kendall MC,Castro Alves LJ,De Oliveira G.Liposome Bupivacaine Compared to Plain Local Anesthetics to Reduce Postsurgical Pain:An Updated Meta-Analysis of Randomized Controlled Trials[J].Pain Res Treat,2018(2018):5710169. [4]Albrecht E,Kern C,Kirkham KR.A systematic review and meta-analysis of perineural dexamethasone for peripheral nerve blocks[J].Anaesthesia,2015(70):71-83. [5]Emelife PI,Eng MR,Menard BL,et al.Adjunct medications for peripheral and neuraxial anesthesia[J].Best Pract Res Clin Anaesthesiol,2018,32(2):83-99. [6]Brummett CM,Hong EK,Janda AM,et al.Perineural dexmedetomidine added to ropivacaine for sciatic nerve block in rats prolongs the duration of analgesia by blocking the hyperpolarization-activated cation current[J].Anesthesiology,2011,115(4):836-843. [7]Sarotti D,Rabozzi R,Franci P.Effects of intravenous dexmedetomidine infusion on local anaesthetic block:A spinal anaesthesia clinical model in dogs undergoing hind limb surgery[J].Res Vet Sci,2019(124):93-98. [8]Abdallah FW,Johnson J,Chan V,et al.Intravenous dexamethasone and perineural dexamethasone similarly prolong the duration of analgesia after supraclavicular brachial plexus block:A randomized,triple-arm,double-blind,placebo-controlled trial[J].Reg Anesth Pain Med,2015(40):125-132. [9]Wang HL,Zhang GY,Dai WX,et al.Dose-dependent neurotoxicity caused by the addition of perineural dexmedetomidine to ropivacaine for continuous femoral nerve block in rabbits[J].J Int Med Res,2019,47(6):2562-2570. [10]董萍,张肖怡,郭政.右美托咪定对糖尿病患者围术期心肌保护及心血管功能调控作用[J].山西医科大学学报,2019,50(4):516-520. [11]Andersen JH,Jaeger P,Grevstad U,et al.Systemic dexmedetomidine is not as efficient as perineural dexmedetomidine in prolonging an ulnar nerve block[J].Reg Anesth Pain Med,2019.

相似文献/References:

[1]黄艳东.不同剂量氢吗啡酮用于膝关节置换术后硬膜外镇痛的临床观察[J].医学信息,2018,(01):85.[doi:10.3969/j.issn.1006-1959.2018.01.030]
 HUANG Yan-dong.Clinical Observation of Epidural Analgesia after Knee Arthroplasty with Different Doses of Hydromorphine[J].Medical Information,2018,(19):85.[doi:10.3969/j.issn.1006-1959.2018.01.030]
[2]杨进斌,韩建阁.右美托咪定复合丙泊酚和芬太尼在无痛人流术中的应用观察[J].医学信息,2018,(03):134.[doi:10.3969/j.issn.1006-1959.2018.03.047]
 YANG Jin-bin,HAN Jian-ge.Application of Dexmetomidine Combined with Propofol and Fentanyl in Painless Induced Abortion[J].Medical Information,2018,(19):134.[doi:10.3969/j.issn.1006-1959.2018.03.047]
[3]侯 江.舒芬太尼联合右美托咪定用于临床麻醉的效果观察[J].医学信息,2018,(03):144.[doi:10.3969/j.issn.1006-1959.2018.03.051]
 HOU Jiang.Clinical Observation on the Effect of Sufendate Combined with Dexlansoprazole in Clinical Anesthesia[J].Medical Information,2018,(19):144.[doi:10.3969/j.issn.1006-1959.2018.03.051]
[4]陶 晶,王 鑫,黄 擘,等.右美托咪定对截肢术后发生谵妄的疗效观察[J].医学信息,2018,(04):123.[doi:10.3969/j.issn.1006-1959.2018.04.043]
 TAO Jing,WANG Xin,HUANG Bo,et al.Therapeutic Effect of Dexmedetomidine on Delirium after Amputation[J].Medical Information,2018,(19):123.[doi:10.3969/j.issn.1006-1959.2018.04.043]
[5]江亚楠,梁永新,施彩凤,等.右美托咪定在大鼠脊髓缺血再灌注损伤中的 保护作用及机制研究[J].医学信息,2018,(07):69.[doi:10.3969/j.issn.1006-1959.2018.07.022]
 JIANG Ya-nan,LIANG Yong-xin,SHI Cai-feng,et al.Protective Effects and Mechanism of Dexmedetomidine on Spinal Cord Ischemia-Reperfusion Injury in Rats[J].Medical Information,2018,(19):69.[doi:10.3969/j.issn.1006-1959.2018.07.022]
[6]孙素花,宋建防,褚海辰,等.右美托咪定经鼻给药在胸腔镜肺叶切除术中的疗效观察[J].医学信息,2018,(07):78.[doi:10.3969/j.issn.1006-1959.2018.07.025]
 SUN Su-hua,SONG Jian-fang,CHU Hai-chen,et al.Efficacy of Dexmetomidine in Thoracoscopic Lobectomy by Nasal Administration[J].Medical Information,2018,(19):78.[doi:10.3969/j.issn.1006-1959.2018.07.025]
[7]王绪飞,梁永新.右美托咪定复合布比卡因骶管阻滞对预防七氟醚 小儿麻醉苏醒期躁动的观察分析[J].医学信息,2018,(08):78.[doi:10.3969/j.issn.1006-1959.2018.08.024]
 WANG Xu-fei,LIANG Yong-xin.Observation of Dexmedetomidine Combined with Bupivacaine Caudal Block in Preventing Sedation in Children with Sevoflurane during Anesthesia Recovery Period[J].Medical Information,2018,(19):78.[doi:10.3969/j.issn.1006-1959.2018.08.024]
[8]李 璟,蒋 娜,王晶晶,等.右美托咪定对H9C2心肌细胞缺氧/复氧损伤的保护作用[J].医学信息,2018,(09):83.[doi:10.3969/j.issn.1006-1959.2018.09.025]
 LI Jing,JIANG Na,WANG Jing-jing,et al.Protective Effects of Dexmedetomidine on Hypoxia/Reoxygenation Injury in H9C2 Cardiomyocytes[J].Medical Information,2018,(19):83.[doi:10.3969/j.issn.1006-1959.2018.09.025]
[9]庞 博,孙雪峰.小剂量不同浓度罗哌卡因在腰硬联合麻醉 前列腺电切术中的效果对比[J].医学信息,2018,(09):112.[doi:10.3969/j.issn.1006-1959.2018.09.033]
 PANG Bo,SUN Xue-feng.Comparison of Effects of Low Dose Ropivacaine with Different Concentrations Combined Spinal-epidural Anesthesia during Prostatic Electrocision[J].Medical Information,2018,(19):112.[doi:10.3969/j.issn.1006-1959.2018.09.033]
[10]赵 亮,王绍林.右美托咪定滴鼻和七氟烷吸入对患儿麻醉前镇静和 苏醒后躁动的影响[J].医学信息,2018,(10):124.[doi:10.3969/j.issn.1006-1959.2018.10.040]
 ZHAO Liang,WANG Shao-lin.Effects of Dexmedetomidine Dripping and Seven Halothane Inhalation on Sedation and Recovery Agitation after Anesthesia in Children[J].Medical Information,2018,(19):124.[doi:10.3969/j.issn.1006-1959.2018.10.040]

更新日期/Last Update: 2019-10-01