右美托咪定复合不同浓度罗哌卡因对行下肢神经阻滞麻醉患者的镇痛效果观察

Analgesic Effect of Dexmedetomidine Combined with Different Concentrations of Ropivacaine on Patients with Lower Limb Nerve Block Anesthesia

探讨右美托咪定复合不同浓度罗哌卡因对行下肢神经阻滞麻醉患者的镇痛效果和安全性,同时评价其临床效果。选取该院2017年8月至2019年6月收治的78例在下肢神经阻滞麻醉下行下肢手术的患者,分别采用右美托咪定复合0. 2%罗哌卡因和0. 15%的罗哌卡因麻醉,观察两组术后镇痛效果,并观察不良反应发生情况。术后8,12,24 h观察组患者静息态和运动态VAS评分均低于对照组(P <0. 05)。术后8,12,24 h观察组患者Ramsay镇静评分高于对照组(P <0. 05)。术后8,12,24 h观察组股四头肌肌力明显高于对照组(P <0. 05)。不良反应观察组总发生率为5. 13%,对照组总发生率为7. 69%,两组不良反应发生率无明显差异(P> 0. 05);观察组和对照组各2例患者出现恶心,经治疗后缓解。结论:400μg右美托咪定复合1. 5%罗哌卡因可为下肢神经阻滞患者提供良好的术后镇静和镇痛,并保护患者股四头肌肌力,促进术后早期功能锻炼,同时具有较好的安全性,有良好临床应用价值。

To investigate the analgesic effect and safety of dexmedetomidine combined with different concentrations of ropivacaine in patients with lower limb nerve block anesthesia,the clinical effect was evaluated. A total of 78 patients who underwent lower extremity surgery with lower extremity nerve block anesthesia from August 2017 to June 2019 were collected and divided into observation group and control group. The observation group were treated with dexmedetomidine combined with 0. 2% ropivacaine and the control group were treated with dexmedetomidine combined with 0. 15% ropivazone. Analgesic effect of the two groups and occurrence of adverse reactions were observed,and the clinical effect was observed. The resting and motor VAS scores of the observation group were significantly lower than those of the control group at 8,12 and 24 hours after operation( P < 0. 05). The Ramsay sedation scores of the observation group were significantly higher than those of the control group at 8,12 and 24 hours after operation( P < 0. 05). At 4,12,and 24 h after operation,the muscle strength of the quadriceps muscle was significantly higher than that of the control group( P < 0. 05). The total incidence rate of observation group was 5. 13%,and the total incidence rate of control group was 7. 69%.There was no significant difference in the incidence of adverse reactions between the two groups( P > 0. 05). Two patients in the observation group and two patients in the control group developed nausea respectively;four patients were relieved after treatment.400 μg dexmedetomidine combined with 1. 5% ropivacaine can provide good postoperative sedation and analgesia for patients with lower limb nerve block,and protect the quadriceps muscle strength of patients,and promote early functional exercise. At the same time,it has better safety with high clinical application value.