罗哌卡因联合右美托咪定腹横肌平面阻滞在急性阑尾炎手术患儿中的应用

Application of Ropivacaine Combined with Dexmedetomidine for Transversus Abdominis Plane Block in Children with Acute Appendicitis

目的探讨罗哌卡因联合右美托咪定腹横肌平面阻滞(TAPB)在急性阑尾炎手术患儿中的应用效果。方法回顾性收集我院2018年9月至2019年10月收治的82例行急性阑尾炎手术患儿临床资料,所有患儿均采用TAPB,按照应用药物的不同分为两组,对照组41例采用罗哌卡因,观察组(41例)采用罗哌卡因联合右美托咪定。对两组术后2h、12h、24h疼痛评分(VAS)进行评估,并对比两组术前、麻醉后10min、手术结束时血流动力学[心率(HR)、平均动脉压(MAP)]。结果两组术后2h、12h、24h VAS评分逐渐升高,但观察组术后2h、12h、24h VAS评分均低于对照组,组间、时点、组间·时点比较,差异有统计学意义(P<0.05);两组术前、麻醉10min后、手术结束时HR、MAP水平逐渐升高,但观察组术前、麻醉10min后、手术结束时HR、MAP水平均低于对照组,组间、时点、组间·时点比较,差异有统计学意义(P<0.05)。结论罗哌卡因联合右美托咪定TAPB镇痛效果较好,且可稳定急性阑尾炎手术患儿血流动力学,安全性较好。

Objective To investigate the effect of ropivacaine combined with dexmedetomidine in transverse abdominis plane block(tapb)in children with acute appendicitis.Methods the clinical data of 82 cases of children with acute appendicitis in our hospital from September 2018 to October 2019 were retrospectively collected.All children were treated with tapb and divided into two groups according to the different drugs used.The control group(41 cases)was treated with ropivacaine and the observation group(41 cases)was treated with ropivacaine combined with dexmedetomidine.The pain scores(VAS)at 2h,12h and 24h after operation were evaluated,and the hemodynamics[heart rate(HR),mean arterial pressure(map)]before operation,10 min after anesthesia and at the end of operation were compared between the two groups.Results the VAS scores at 2h,12h and 24h after operation in the two groups increased gradually,but the VAS scores at 2h,12h and 24h after operation in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05);The levels of HR and map increased gradually before operation,10 minutes after anesthesia and at the end of operation in the two groups,but the levels of HR and map before operation,10 minutes after anesthesia and at the end of operation in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion the analgesic effect of ropivacaine combined with dexmedetomidine tapb is good,and it can stabilize the hemodynamics of children with acute appendicitis surgery,with good safety.