罗哌卡因复合右美托咪定肋间神经阻滞用于胸腔镜术后镇痛的效果

Effects of intercostal nerve block with ropivacaine combined with dexmedetomidine after thoracoscopy

目的探讨罗哌卡因复合右美托咪定行肋间神经阻滞对胸腔镜手术患者术后的镇痛效果。方法拟行胸腔镜手术患者50例,随机均分为两组:右美托咪定组(DEX组),右美托咪定1μg/kg+0.375%罗哌卡因至30ml;对照组(C组),0.375%罗哌卡因30ml。观察两组患者术后4、8、12、24和48h静息状态和躯体活动(如咳嗽)时的疼痛VAS评分及Ramsay镇静评分,并观察两组患者术后镇痛维持时间及术后不良反应发生情况。结果术后4、8、12hDEX组静息状态、躯体活动时的VAS评分均明显低于C组(P<0.01),术后4、8、12h Ramsay镇静评分DEX组明显高于C组(P<0.05)。DEX组术后镇痛维持时间明显长于C组(P<0.01),两组均无肋间神经阻滞的相关并发症。结论 1μg/kg右美托咪定可显著增强0.375%罗哌卡因肋间神经阻滞效果,延长胸腔镜术后镇痛时效。

Objective To investigate the effects of intercostal nerve block with ropivacaine combined with dexmedetomidine after horacoscopy. Methods fifty patients undergoing elective thoracoscopy were randomized into two groups： group DEX, 1 μg/kg of dexmedetomidine combined with 30 ml of ropivacaine; control group （group C）, 30 ml of ropivacaine, the visual analogue scale （VAS） of pain at rest and physical activity state （eg, cough） and the Ramsay scores were assessed within 48 h after operation, and the duration of analgesia, and the adverse reaction were recorded. Results At 4,8 and 12 h, the VAS of pain in the group DEX was significantly lower than the group C（P〈0.01） ,but no difference were observed at 24 and 48 h. The Ramsay scores in the group DE）（ was higher than the group C at 4,8 and 12 h （P〈0. 05）. The duration of analgesia in the DEX group was significantly longer than the comparison （P 〈 0. 01 ）. No complications were observed in both groups. Conclusion 1μg/kg of dexmedetomidine can significantly enhance the effect of intercostal nerve block with ropivacaine 0. 375%, and prolong the duration of analgesia after thoracoscopy.