右美托咪定联合罗哌卡因在低位硬膜外麻醉中的应用效果及安全性

Application effect and safety of dexmedetomidine combined with ropivacaine in low epidural anesthesia

目的探讨右美托咪定联合罗哌卡因在低位硬膜外麻醉中的应用效果及安全性。方法选取在我院实施低位硬膜外麻醉的120例手术患者作为研究对象,采用随机抽签法将其分为试验组(60例,右美托咪定联合罗哌卡因麻醉)和参照组(60例,罗哌卡因麻醉)。比较两组的麻醉效果、生化指标、生命体征及不良反应发生情况。结果试验组的感觉阻滞生效时间短于参照组,感觉阻滞维持时间长于参照组(P<0.05);试验组的视觉模拟评分法(VAS)评分低于参照组,Ramsay镇静评分高于参照组(P<0.05)。麻醉后24 h,试验组的超氧化物歧化酶(SOD)、碱性成纤维细胞生长因子(bFGF)水平高于参照组,丙二醛(MDA)水平低于参照组(P<0.05)。麻醉开始10、30 min及手术完成时,试验组的心率(HR)、平均动脉压(MAP)均明显低于参照组(P<0.05)。试验组的不良反应总发生率明显低于参照组(P<0.05)。结论右美托咪定联合罗哌卡因在低位硬膜外麻醉中的应用效果显著,可降低麻醉对于患者心肺功能、血液循环的影响,提高麻醉安全性。

Objective To investigate the application effect and safety of dexmedetomidine combined with ropivacaine in low epidural anesthesia.Methods A total of 120 surgical patients who underwent low epidural anesthesia in our hospital were selected as the research objects,and the patients were divided into experimental group(60 cases,dexmedetomidine combined with ropivacaine anesthesia)and reference group(60 cases,ropivacaine anesthesia)by random drawing method.The anesthetic effect,biochemical indexes,vital signs and occurrence of adverse reactions were compared between the two groups.Results The effective time of sensory block in the experimental group was shorter than that in the reference group,and the mointencomce time of sensory block was longer than that in the reference group(P<0.05);the Visual Analogue Scale(VAS)score in the experimental group was lower than that in the reference group,and the Ramsay sodation score was higher than that in the reference group(P<0.05).At 24 h after anesthesia,the levels of superoxide dismutase(SOD)and basic fibroblast growth factor(bFGF)in the experimental group were higher than those in the reference group,and the level of malondialdehyde(MDA)was lower than that in the reference group(P<0.05).At 10 and 30 min after anesthesia and after operation,the heart rate(HR)and mean artery pressure(MAP)in the experimental group were significantly lower than those in the reference group(P<0.05).The total incidence of adverse reactions in the experimental group was significantly lower than that in the reference group(P<0.05).Conclusion Dexmedetomidine combined with ropivacaine in low epidural anesthesia has a significant application effect,which can reduce the influence of anesthesia on cardiopulmonary function and blood circulation of patients,and improve the safety of anesthesia.