摘要
目的观察右美托咪定对罗哌卡因关节腔注射用于膝关节镜术后镇痛半数有效剂量（ED。）的影响。方法择期膝关节镜诊治术患者60例，美国麻醉医师协会评分标准（ASA）Ⅰ或Ⅱ级，年龄30-56岁，性别不限，随机分为2组（n=30）：对照组（R组）患者关节腔内注入不同浓度岁哌卡因；右美托咪定联合罗哌卡因组（RD组）患者关节腔内注射不同浓度罗哌卡因和1μg／kg右美托咪定的混合液。以术后2h视觉模拟评级法（VAS）评分低于3分为镇痛有效，采用序贯法确定罗哌蕾因浓度，用Dixon-Massey法确定ED50及其95％可信区间（CI）。结果两组患者年龄、体质量、性别比以及手术时间比较差异无统计学意义（P〉0．05）。R组ED50为4．85mg，95％CI：4．826—4．874；RD组ED50为3．53mg，95％CI：3．506～3．554。结论右美托咪定对罗哌卡因膝关节腔注射术后镇痛具有协同作用，可以减少罗哌卡因的用药剂量。
Objective To observe the minimmn effective local anesthetic dose of intra -articular ropivacaine with dexmedetomidine for analgesia after knee arthroscopy. Methods Sixty patients subject to knee arthroscopy under total intravenous anesthesia were randomly divided into two groups （ n = 30 each） ： control group （group R） and the ropivacaine with dexmedetomidine group （group liD）. The ropivacaine was injected intra- articularly in group R, and dexmedetomidine （1 μg/kg） with ropivacaine was injected intra - articularly in group RD. Median effective close （ ED50 ） of ropivacaine was determined by the sequence method. The effective criteria were as follows： Visual Analogue Scale/Score ≤3 two h after operation. The initial dose was 3 mg and according to the effective or ineffective results in previous patient, a dose of ropivacaine was decreased or increased 1.1 times to previous patient. Results The ages, weight and sex ratio be- tween two groups showed no significant difference. ED50 of ropivaeaine for analgesia after knee arthroscopy was 4. 85 nag [95% confidence interval （C1） ： 4. 826 -4. 874], and EDso of ropivacaine with dexmedetomi- dine for analgesia after knee arthroseopy was 3.53 mg （95% CI 3.506 - 3. 554）. Conclusion lntra - articu- lar administration of ropivacaine with dexmedetomidine could provide superior postoperative analgesia. The dose of ropivacaine for analgesia after knee arthroscopy should be reduced with dexmedetomidine.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2015年第8期2008-2010,共3页
Chinese Journal of Experimental Surgery
关键词
右美托咪定
罗哌卡因
膝关节镜
术后镇痛
Knee arthroscopy
Ropivaeaine
Dexmedetomidine
Postoperative analgesia
