[1]李紫薇.不同剂量右美托咪定复合罗哌卡因超声引导下髂筋膜间隙阻滞对老年全髋关节置换术血流动力学、麻醉效果的影响[J].医学信息,2023,36(13):91-94,130.[doi:10.3969/j.issn.1006-1959.2023.13.017]
　LI Zi-wei.Effects of Different Doses of Dexmedetomidine Combined with Ropivacaine on Hemodynamics and Anesthetic Effect of Ultrasound-guided Fascia Iliaca Compartment Block in Elderly Patients Undergoing Total Hip Arthroplasty[J].Journal of Medical Information,2023,36(13):91-94,130.[doi:10.3969/j.issn.1006-1959.2023.13.017]
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不同剂量右美托咪定复合罗哌卡因超声引导下髂筋膜间隙阻滞对老年全髋关节置换术血流动力学、麻醉效果的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年13期
页码:
91-94,130
栏目:
论著
出版日期:
2023-07-01

文章信息/Info

Title:
Effects of Different Doses of Dexmedetomidine Combined with Ropivacaine on Hemodynamics and Anesthetic Effect of Ultrasound-guided Fascia Iliaca Compartment Block in Elderly Patients Undergoing Total Hip Arthroplasty
文章编号:
1006-1959（2023）13-0091-05
作者:
李紫薇
（徐州医科大学附属医院麻醉科，江苏 徐州 221004）
Author(s):
LI Zi-wei
(Department of Anesthesiology,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221004,Jiangsu,China)
关键词:
右美托咪定; 罗哌卡因; 髂筋膜间隙阻滞; 老年全髋关节置换术; 血流动力学; 麻醉效果
Keywords:
Dexmedetomidine; Ropivacaine; Iliofascial space block; Total hip replacement in the elderly; Hemodynamics; Anesthetic effect
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2023.13.017
文献标志码:
A
摘要:
目的 探讨不同剂量右美托咪定复合罗哌卡因超声引导下髂筋膜间隙阻滞对老年全髋关节置换术血流动力学、麻醉效果的影响。方法 选取2021年11月-2022年11月在我院行全髋关节置换术的老年患者88例，根据随机数字表法分为A、B、C、D共4组，每组22例。A组采用0.3%罗哌卡因治疗，B组采用0.5 μg/kg右美托咪定联合0.3%罗哌卡因治疗，C组采用1.0 μg/kg右美托咪定联合0.3%罗哌卡因治疗，D组采用1.5 μg /kg右美托咪定联合0.3%罗哌卡因治疗，比较4组术后4、8、12、24 h 疼痛情况（VAS评分）、麻醉前（T0）、麻醉后（T1）、手术结束（T2）时心率（HR）、平均动脉压（MAP）、镇痛效果、围手术期阻滞起效时间、阻滞消退时间、下床活动时间及住院时间。结果 4组术后4、8、12、24 h VAS比较，差异有统计学意义（P＜0.05）；A 组与B 组 VAS 评分比较，差异无统计学意义（P＞0.05）；C组、D组术后4、8、12、24 h VAS比较，差异无统计学意义（P＞0.05）；C组、D组术后4、8、12、24 h VAS评分均低于A组、B组，差异有统计学意义（P＜0.05）；A 组、B 组T1、T2时HR、MAP比较，差异无统计学意义（P＞0.05）；C组、D组T1、T2时HR、MAP比较，差异无统计学意义（P＞0.05）；C组D组T1、T2时HR、MAP均低于A组、B组，差异有统计学意义（P＜0.05）；D组（95.45%）与C组（90.91%）麻醉效果高于A组（59.09%）、B组（63.64%），差异有统计学意义（P＜0.05）；A组阻滞起效时间、下床活动时间、住院时间长于B、C、D组，阻滞消退时间短于B、C、D组，差异有统计学意义（P＜0.05）；B组阻滞起效时间、下床活动时间、住院时间长于C组、D组，差异有统计学意义（P＜0.05）；C组和D组阻滞起效时间、下床活动时间、住院时间比较，差异无统计学意义（P＞0.05）；C组D组阻滞起效时间、消退时间、下床活动时间、住院时间短于A组、B组，差异有统计学意义（P＜0.05）。结论 1.0 μg/kg与1.5 μg/kg右美托咪定联合0.3%罗哌卡因应用于超声引导下髂筋膜间隙阻滞老年全髋关节置换术镇痛麻醉效果良好，能够有效稳定血流动力学指标，缩短住院时间，值得临床应用。
Abstract:
Objective To investigate the effects of different doses of dexmedetomidine combined with ropivacaine on hemodynamics and anesthetic effect of ultrasound-guided fascia iliaca compartment block in elderly patients undergoing total hip arthroplasty.Methods A total of 88 elderly patients who underwent total hip arthroplasty in our hospital from November 2021 to November 2022 were selected and divided into groups A, B, C and D according to the random number table method, with 22 patients in each group. Group A was treated with 0.3% ropivacaine, group B was treated with 0.5 μg/kg dexmedetomidine combined with 0.3% ropivacaine, group C was treated with 1.0 μg/kg dexmedetomidine combined with 0.3% ropivacaine, and group D was treated with 1.5 μg/kg dexmedetomidine combined with 0.3% ropivacaine. The pain (VAS score) at 4, 8, 12 and 24 h after operation, heart rate (HR), mean arterial pressure (MAP) before anesthesia (T0), after anesthesia (T1) and at the end of operation (T2), analgesic effect, perioperative block onset time, block regression time, ambulation time and hospitalization time were compared among the four groups.Results There were significant differences in VAS at 4, 8, 12 and 24 h after operation among the four groups (P<0.05). There was no significant difference in VAS score between group A and group B (P>0.05). There was no significant difference in VAS at 4, 8, 12 and 24 h after operation between group C and group D (P>0.05). The VAS scores of group C and group D at 4, 8, 12 and 24 h after operation were lower than those of group A and group B, and the differences were statistically significant (P<0.05). There was no significant difference in HR and MAP between group A and group B at T1 and T2 (P>0.05). There was no significant difference in HR and MAP between group C and group D at T1 and T2 (P>0.05). HR and MAP at T1 and T2 in group D were lower than those in group A and group B, and the differences were statistically significant (P<0.05). The anesthetic effect of group D (95.45%) and group C (90.91%) was higher than that of group A (59.09%) and group B (63.64%), and the difference was statistically significant (P<0.05). The onset time of block, ambulation time and hospitalization time in group A were longer than those in groups B, C and D, and the regression time of block was shorter than that in groups B, C and D, the differences were statistically significant (P<0.05). The onset time of block, ambulation time and hospitalization time in group B were longer than those in group C and group D, and the differences were statistically significant (P<0.05). There was no significant difference in the onset time of block, the time of getting out of bed and the time of hospitalization between group C and group D (P>0.05). The onset time, regression time, ambulation time and hospitalization time of group D were shorter than those of group A and group B, and the differences were statistically significant (P<0.05).Conclusion The application of 1.0 μg/kg and 1.5 μg/kg dexmedetomidine combined with 0.3% ropivacaine in ultrasound-guided fascia iliaca compartment block for elderly patients undergoing total hip arthroplasty has a good analgesic anesthesia effect, which can effectively stabilize the level of hemodynamic indicators, shorten the length of hospital stay, and is worthy of clinical application.

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更新日期/Last Update: 1900-01-01