摘要
目的：评价罗哌卡因复合右美托咪定髂筋膜间隙阻滞对预防老年髋关节置换术苏醒期躁动的临床效果。方法：选择髋关节置换术患者80例。年龄60～75岁．ASA分级I-Ⅱ级。随机分为两组：右美托咪定复合罗哌卡因组（DR组，n=40）和罗哌卡因组（R组，n=40）。全麻前行超声引导髂筋膜间隙阻滞，DR组予含1μg／kg右美托咪定的0．4％罗哌卡因30mL；R组予0．4％罗哌卡因30mL。记录拔除喉罩时间和恢复室停留时间．以FLACC≤3分为镇痛有效并计算有效率，以RASS≥＋1级为苏醒期躁动计算发生率。结果：两组拔除喉罩时间和恢复室停留时间比较差异无统计学意义（P〉0．05）；与R组比较，DR组镇痛有效率明显升高，苏醒期躁动发生率明显降低（P〈0．05）。结论：0．4％罗哌卡因复合1μg／kg右美托咪定30mL髂筋膜间隙阻滞可明显降低老年髋关节置换术苏醒期躁动发生率。
Objective To evaluate the clinical effect of fascia iliaca compartment block with ropivacaine combined with dexmedetomidine for preventing emergence agitation in elderly patients after hip arthroplasty. Methods Eighty patients （aged 60 -75 y/o, ASA physical status I or Ⅱ ） scheduled for hip arthroplasty are included in the research. Patients were randomly divided into 2 groups （n = 40 each）： ropivacaine mixed with dexmedetomidine group （group DR） and ropivacaine group （group R）. All patients underwent fascia iliaca compartment block guided by ultrasound before general anesthesia. 0.4% ropivacaine mixed with 1μg/kg dexmedetomidine 30 mL were injected in group DR, and 0.4% ropivacaine 30 mL were injected in group R. The time of removing laryngeal mask and the residence time in postanesthesia care unit （PACU） were recorded respectively. The effective rate of analgesia was calculated with FLACC scores no more than three, and the Incidence rate of emergence agitation was calculated with RASS scores greater than or equal ＋ 1 grade. Results There were no difference in 2 groups of the time of removing laryngeal mask and the residence time in PACU （P 〉 0.05）. Compared with group R, the effective rate of analgesia was significantly higher and the incidence rate of emergence agitation was significantly lower （P 〈 0.05） in group DR. Conclusion Fasciailiaca compartment block with 0.4% ropivacaine mixed with 1 μg/kg dexmedetomidine can effectively reduce the incidence rate of emergence agitation in elderly patients after hip arthroplasty.
出处
《实用医学杂志》
CAS
北大核心
2016年第22期3769-3771,共3页
The Journal of Practical Medicine
基金
北京市医院管理局重点医学专业发展计划(编号:ZYLX201506)
关键词
右美托咪定
髂筋膜间隙阻滞
老年
髋关节置换术
苏醒期躁动
Dexmedetomidine
Fascia iliaca compartment block
Elderly
Hip arthroplasty
Emergence agitation
