右美托咪定联合罗哌卡因超前镇痛效果

The effect of dexmedetomidine combined with ropivacaine for preemptive analgesia

目的探讨右美托咪定与罗哌卡因联合对脊柱后路手术超前镇痛效果的影响。方法选取2015年9月-2017年9月佛山市健翔医院107例脊柱后路手术为研究对象,根据不同的麻醉方式将入选的患者分为对照组34例、A组38例及B组35例,A组持续给予右美托咪定至手术结束,B组持续给予盐酸右美托咪定至术后24h,术后3组均于切口给予罗哌卡因局部浸润麻醉,比较各组患者不同麻醉时间点MAP、HR及SpO_2等指标变化及术后镇痛效果。结果 B组T3~T5各时点MAP低于A组;B组T3-T5各时点HR较A组降低;B组拔管后6、24、48 h VAS评分较A组降低,差异有统计学意义(P<0.05)。结论右美托咪定与罗哌卡因联合应用可有效减轻脊柱后路手术的术后疼痛,值得临床推广使用。

Objective To investigate the effect of dexmedetomidine combined with ropivacaine for preemptive analgesia in posterior spinal surgery. Methods From September 2015 to September 2017, 107 cases of posterior spinal surgery in Foshan Jianxiang Hospital were selected as research subjects. According to different anesthesia methods, the patients were divided into control group with 34 cases, A group with38 cases and B group with 35 cases. Dexmedetomidine was continuously given to the A group to the end of the operation, and the B group was continuously given dexmedetomidine hydrochloride to 24 hours after the op eration. Local infiltration of ropivacaine was given to the 3 groups after the operation. The changes of MAP, HR and SpO2 at different time points of anesthesia and postoperative analgesic effect were compared in each group. Results The MAP of T3-T5 in group B was significantly lower than that in group A, the HR of T3-T5 in group B was significantly lower than that in A group, the VAS scores of 6, 24 and 48 hours after extubation in group B were significantly lower than those in group A, the differences were statistically significant（P〈0.05）. Conclusion Dexmedetomidine combined with ropivacaine can effectively reduce postoperative pain after posterior spinal surgery. It is worth popularizing in clinical practice.