摘要
目的观察右美托咪定复合肋间神经阻滞在食管癌根治术患者的应用效果。方法食管癌根治术患者60例随机均分为两组:DEX组肋间神经阻滞后10min内静脉泵注右美托咪定0.5μg/kg;NS组肋间神经阻滞,不用右美托咪定。记录患者术前及术后各时间点HR、BP、RR、PaO_2、PaCO_2和VAS疼痛评分;比较两组患者拔管期间呛咳评分、躁动评分及术后不良事件的发生率。结果拔管期间DEX组呛咳评分和躁动评分均低于NS组(P<0.01),NS组HR、BP均高于DEX组,且高于诱导前(P<0.01)。术后,DEX组Ramsay评分高于NS组(P<0.05或P<0.01),NS组寒战发生率高于DEX组(P<0.01),DEX组术后12h和24h的VAS疼痛评分低于NS组(P<0.01)。结论右美托咪定复合肋间神经阻滞能有效维持循环稳定,增强术后镇痛,减少术后寒战的发生。
Objective To observe the efficacy of dexmedetomidine combined with intercostal nerve block （ICNB） in patients undergoing radical surgery for esophageal cancer. Methods Sixty patients undergoing radical surgery for esophageal cancer were randomly and equally divided into two groups. Group DEX was given ICNB and intravenous infusion of dexmedetomidine 0. 5 μg/kg in 10 minutes before anesthesia induction. Group NS was given ICNB alone. The HR, BP, RR, PaO2and PaCO2 were monitored perioperatively. The scores of coughing, dysphoria during extubation were evaluated and VAS pain scores we：re recorded after operation. Results The scores of coughing and dysphoria during extubation were lower in group DEX than those in group NS（P〈0. 01）. BP and HR during extubation were lower in group DEX than those in group NS（P〈0. 01）. After operation, Ramsay score was significantly higher, incidence of shivering and VAS pain scores at 12 and 24 hours after operation were lower,in group DEX than those in group NS（P〈0. 05 or P〈0.01）. Conclusion Dexrnedetomidine combined with ICNB can effectively maintain circulation stable, enhance postoperative analgesia and reduce 1：he incidence of shivering.
出处
《江苏医药》
CAS
2015年第24期2977-2980,共4页
Jiangsu Medical Journal
关键词
右美托咪定
肋间神经阻滞
食管癌根治术
Dexmedetomidine
Intercostal nerve block
Radical resection of esophagealcarcinoma
