右美托咪定复合腹横筋膜阻滞在吗啡泵植入术中的应用

Application of dexmedetomidine combined with transversus abdominis plane block in the implantation of morphine pump

目的讨论右美托咪定复合腹横筋膜阻滞在吗啡泵植入术中的应用效果。方法选取深圳市人民医院2018年5月至2020年5月吗啡泵植入术患者60例,按随机双盲法将其中30例作为对照组(实施0.25%罗哌卡因20 ml),30例作为试验组(给予右美托咪定1μg/kg),分析两组疼痛程度、生命体征、不良反应等症状,并观察镇痛维持时长、麻醉药物用量及麻醉阻滞起效时长。结果试验组不同阶段的疼痛评分低于对照组(P<0.05);两组实施前指标比较,差异无统计学意义(P>0.05),实施后两组指标均明显改善,但试验组血压、血氧饱和度以及心率优于对照组(P<0.05);试验组不良症状总发生率为6.67%,显著低于对照组的40.00%(P<0.05);试验组镇痛维持时间、麻醉药物使用剂量以及麻醉阻滞起效时间显著短/少于对照组(P<0.05)。结论右美托咪定复合腹横筋膜阻滞在吗啡泵植入术中的应用效果显著,可延长镇痛效果,减少不良反应,促进临床指标改善,值得推广。

Objective To discuss the application effect of dexmedetomidine combined with transversus abdominis plane block in the implantation of morphine pump.Methods A total of 60 patients who underwent the implantation of morphine pump in Shenzhen People's Hospital from May 2018 to May 2020 were included in this study.According to the random double-blind method,30 patients were selected as the control group(given 0.25%ropivacaine 20 ml),and the rest 30 patients were selected as the experimental group(given dexmedetomidine 1 g/kg).The pain degree,vital signs,adverse reactions and other symptoms of the two groups were analyzed,and the duration of analgesia,the anesthetic dosage and the onset time of anesthesia block were observed.Results The pain indicators in different stages of the experimental group were significantly better than those of the control group,with statistically significant differences(P<0.05).There were no statistically significant differences in the indicators between the two groups before the medication(P>0.05).After the medication,the indicators of the two groups were significantly improved,but the blood pressure,blood oxygen saturation and heart rate in the experimental group were better than those in the control group,with statistically significant differences(P<0.05).The overall incidence of adverse reactions in the experimental group was 6.67%,which was significantly lower than that of 40.00%in the control group,with statistically significant difference(P<0.05).The duration of analgesia,the anesthetic dosage and the onset time of anesthesia block in the experimental group were significantly better than those in the control group,with statistically significant differences(P<0.05).Conclusion The application of dexmedetomide combined with transversus abdominis plane block in the implantation of morphine pump shows significant effect,which can effectively prolong the analgesic effect,reduce the occurrence of adverse reactions and improve the changes of various clinical indicators.Therefore,it is worthy of clinical application and promotion.