右美托咪定复合罗哌卡因用于儿童术后骶管麻醉镇痛的效果

Efficacy of postoperative caudal epidural analgesia with dexmedetomidine combined with ropivacaine in children

目的观察右美托咪定复合罗哌卡因骶管麻醉(骶麻)用于儿童下腹部手术术后镇痛的临床效果。方法小儿外科择期行全身麻醉下腹部手术患儿98例随机分两组,每组49例。手术结束时实施骶麻术后镇痛:DR组镇痛药溶液为0.125%罗哌卡因和1μg/kg的右美托咪定混合液,R组镇痛药溶液为0.125%的罗哌卡因,镇痛药溶液总量10 mL。术后1、6和12 h评估Ramsay镇静评分和Wong-Baker面部表情量表评分。记录两组患儿拔管时躁动评分及镇痛相关不良反应发生情况。结果与R组比较,DR组患儿术后1、6和12 h的Ramsay镇静评分升高,Wong-Baker表情评分降低(P<0.05)。DR组患儿拔管时躁动评分低于R组(P<0.05),寒战发生率也低于R组(P<0.05)。结论右美托咪定复合罗哌卡因骶麻术后镇痛的镇痛效果较罗哌卡因单用更好,不良反应少。

Objective To observe the efficacy of postoperative caudal epidural analgesia with dexmedetomidine combined with ropivacaine in the children underwent lower abdominal surgery.Methods Ninety-eight children undergoing elective lower abdominal surgery under general anesthesia were randomly assigned into two groups with 49 cases each.At the end of operation,the children in both groups were given caudal epidural block with an injection of 10 mL analgesic solution containing 0.125%ropivacaine and dexmedetomidine 1μg/kg in group DR or containing 0.125%ropivacaine alone in group R.The agitation score during extubation was evaluated.The Ramsay sedation score and Wong-Baker facial expression scale were evaluated at 1 hour,6 hours and 12 hours after operation.Caudal epidural analgesia-related adverse responses were recorded.Results Compared with group R,the Ramsay scores were significantly higher and the Wong-Baker expression scores were significantly lower in group DR at 1 hour,6 hours and 12 hours after operation(P<0.05).The score of agitation during extubation in group DR was lower than that in group R(P<0.05).The incidence of chills during extubation in group DR was significantly lower than that in group R(P<0.05).ConclusionThe postoperative analgesic effect of caudal epidural analgesia with dexmedetomidine combined with ropivacaine is better than that with ropivacaine alone with less analgesia-related adverse responses in the children undergoing lower abdominal surgery.