右旋美托咪啶和咪达唑仑对罗哌卡因腰部麻醉作用的影响

Effect of Dexmedetomidine and Midazolam for Spinal Anesthesia with Ropivacaine

目的探讨和比较应用右旋美托咪啶和咪达唑仑对罗哌卡因腰部麻醉作用的影响。方法选择我院2012年9月至2013年9月收治的81例行经尿道前列腺切除患者并随机分为三组,每组27例。其中A组静注右旋美托咪啶,B组静注咪达唑仑,C组静注生理盐水,比较三种药物对罗哌卡因腰部麻醉作用的效果。结果 A组最高感觉阻滞平面明显高于B组和C组(P<0.05);在感觉阻滞消退两个节段和术后首次使用镇痛药治疗的时间方面,A组均明显长于B组和C组(P<0.05);在运动阻滞至改良1级的恢复期方面,三组比较差异无统计学意义(P>0.05);A、B两组拉姆齐镇静评分均明显高于C组(P<0.05)。结论应用右旋美托咪啶可升高最高感觉阻滞平面,延长罗哌卡因腰部麻醉感觉阻滞时间,术后镇痛及镇静效果也较好。

Objective To observe and compare the effect of dexmedetomidine and midazolam for spinal anesthesia with Ropivacaine. Methods 81 patients with transurethral resection of prostate were randomly divided into three groups, with 27 cases in each group. Patients in group A received dexmedetomidine for intravenous injection, group B received midazolam for intravenous injection, and group C received normal saline for intravenous injection. The clinical effects of three kinds of drugs for spinal anesthesia with ropivacaine were compared. Results The highest level of sense obstacle of group A was significantly higher than that of group B and group C （P〈0.05）. Compared with group B and group C, group A had longer time for two dermatomes regression of sensory blockade, and longer time to first postoperative analgesic request, with statistical differences （P〈0.05）. There was no statistical difference among 3 groups in the recovery of motion block to the improvement of level 1 （P〉0.05）. Compared with group C, both group A and group B had higher Ramsay sedation score, with statistical differences （P〈0.05）. Conclusions Dexmedetomidine can improve highest level of sense obstacle, and prolong the sense obstacle time of spinal anesthesia with ropivacaine. It also has good postoperative analgesia and sedation effect.