盐酸右美托咪定联合罗哌卡因对脊柱后路手术超前镇痛效果的研究

The study of dexmedetomidine combined with ropivacaine on the effect of preemptive analgesia in spine posterior approach

目的研究盐酸右美托咪定（DEX）联合罗哌卡因对脊柱后路手术超前镇痛的效果。方法 75例患者随机分为A组（对照组）、B组（DEX持续至手术结束）、C组（DEX持续至手术结束后24 h）,术后均以罗哌卡因在手术切口局部浸润麻醉。结果与A组相比,B组和C组拔管后6~72 h内疼痛视觉模拟评分（VAS）降低,术后首次镇痛需要时间延迟,盐酸曲马多总量减少（P〈0.05）;C组拔管后VAS评分低于B组（P〈0.05）;B组和C组患者血清皮质醇水平降低（P〈0.05）。结论盐酸右美托咪定持续静脉输注联合手术切口罗哌卡因局部浸润麻醉可显著减轻脊柱后路手术患者的术后疼痛程度,减少术后使用镇痛药物的总量。

Objective To study the preemptive analgesic effect of dexmedetomidine （DEX） combined with ropivacaine in spine posterior approach. Methods A total of 75 patients were randomly divided into three groups： group A（control）, group B （DEX infusion until the end of surgery）, group C （DEX infusion continued until 24h after operation）, and all three groups received local infiltration with ropivacaine around the wound after operation. Results Being compared with group C, the visual analogue scale （VAS） in group B and C was reduced in 6 to 72 h after extubation; the time of ini- tial postoperative analgesia was delayed and the total amount of tramadol was also reduced in group B and C （P〈0.05）. The level of serum cortisol was decreased in group B and C （P〈0.05）. Conclusion Continual infusion of DEX combined with ropivacaine can significantly reduce postoperative pain and the amount of analgesic for patients with spine posterior approach surgery.