右美托咪定复合罗哌卡因超前镇痛对开胸手术病人围术期疼痛控制及血清前列腺素E2、β-内啡肽的影响

The effect of dexmedetomidine combined with ropivacaine preemptive analgesia on the perioperative period pain control and serum PGE2,β-EP in patients undergoing thoracotomy

目的探讨右美托咪定复合罗哌卡因超前镇痛对开胸手术病人围术期疼痛控制及血清前列腺素E2(PGE2)、β-内啡肽(β-EP)的影响。方法行开胸手术治疗的病人80例,随机分为观察组和对照组,每组40例,两组均使用胸椎旁神经阻滞麻醉,对照组使用药物为罗哌卡因,观察组联合右美托咪定。比较两组麻醉效果。结果观察组术后芬太尼镇痛用量少于对照组,差异有统计学意义(P<0.05);观察组拔管时、拔管后5分钟时躁动评分(RS)均低于对照组,差异有统计学意义(P<0.05);观察组术后2小时、6小时、12小时、24小时VAS评分、血清PGE2、β-EP均低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定复合罗哌卡因超前镇痛对开胸手术病人围术期疼痛控制效果满意,降低应激反应程度。

Objective To study the effect of dexmedetomidine combined with ropivacaine preemptive analgesia on the perioperative period pain control and serum prostaglandin E2(PGE2),β-endorphin(β-EP)in patients undergoing thoracotomy.Methods 80 patients with thoracotomy in our hospital were randomly divided into observation group and control group,each group had 40 cases,they were anesthetized by paravertebral nerve block,the control group was given ropivacaine,the observation group was combined with dexmedetomidine,and the anesthesia induction,maintenance and postoperative analgesia were the same in two groups.The anesthesia effect between two groups were compared.Results The dosage of fentanyl in the observation group was significantly less than that in the control group(P<0.05);the RS score of the observation group was lower than that of the control group at the time of extubation and after extubation 5 minutes(P<0.05);the VAS score,serum PGE2 andβ-EP in the observation group were lower than that in the control group at after operation 2 h,6 h,12 h and 24 h(P<0.05).Conclusion Dexmedetomidine combined with ropivacaine has satisfactory effect on perioperative period pain control of patients undergoing thoracotomy,which can avoid the increase of serum PGE2 andβ-EP after craniotomy.