摘要
目的评估右美托咪定(dexmedetomidine,Dex)作为罗哌卡因佐剂用于头皮神经阻滞的安全性和有效性。方法选择2018年3月至12月择期行开颅手术患者50例,男24例,女26例,ASA分级Ⅰ~Ⅲ级,按随机数字表法分为2组(每组25例):对照组(C组)和右美托咪定组(Dex组)。C组用1 ml生理盐水、Dex组用1μg/kg的Dex稀释至1 ml,分别加入0.4%罗哌卡因局部麻醉药中,在全身麻醉诱导前行双侧头皮神经阻滞。比较两组患者术后1、2、6、12、18、24 h的VAS评分、Ramsay镇静评分以及术后24 h内的感觉阻滞时间、需补救镇痛的例数、镇痛满意度评分和术后并发症的情况。结果Dex组术后6、12、18、24 h的VAS评分显著低于C组(P<0.05);两组术后6、12、18、24 h的Ramsay镇静评分差异无统计学意义(P>0.05);术后24 h内Dex组的感觉阻滞时间显著延长,需补救镇痛比例显著降低(P<0.05);两组患者镇痛满意度评分差异无统计学意义(P>0.05);两组患者围手术期不良事件发生率差异无统计学意义(P>0.05)。结论1μg/kg的Dex作为罗哌卡因佐剂用于头皮神经阻滞有效地降低了开颅患者术后VAS评分,为开颅术后镇痛提供了较好的临床方案。
Objective To evaluate the safety and efficacy of dexmedetomidine(Dex)as an adjuvant to ropivacaine in scalp block.Methods Fifty patients,including 24 men and 26 women,American Society of Anesthesiologists(ASA)gradeⅠto Ⅲ,who were scheduled for elective craniotomy in Union Hospital from March to December 2018 were enrolled in the current study.They were randomly divided into two groups(n=25):group C and group Dex.They underwent bilateral scalp nerve block before general anesthesia induction,where 1 ml normal saline in 0.4%ropivacaine was used for group C,and 1μg/kg Dex diluted into 1 ml normal saline in 0.4%ropivacaine was used for group Dex.Then,both groups were compared for Visual Analogue Scale(VAS)scores and Ramsay sedation scores 1,2,6,12,18 h and 24 h after craniotomy.Meanwhile,the duration of sensory block,the need for rescue analgesia,analgesic satisfaction scores and postoperative complications were recorded with 24 h after craniotomy.Results Compared with group C,remarkable decreased VAS scores were found in group Dex 6,12,18 h and 24 h after surgery(P<0.05).There were no statistical differences in Ramsay sedation scores between the two groups 6,12,18 h and 24 h after surgery(P>0.05).Group Dex presented markedly extended duration of sensory block and reduced need for rescue analgesia within 24 h after surgery(P<0.05).There were no statistical differences in analgesic satisfaction scores between the two groups(P>0.05).No significant difference was found in the incidence of peri-operative adverse reactions between the two groups(P>0.05).Conclusions The use of 1μg/kg Dex as an adjuvant to ropivacaine for scalp block can effectively reduce VAS scores in patients after craniotomy,which provides better management of postoperative analgesia.
作者
吕晶
吴茜
吴志林
姚尚龙
Lyu Jing;Wu Xi;Wu Zhilin;Yao Shanglong(Department of Anesthesiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)
出处
《国际麻醉学与复苏杂志》
CAS
2019年第11期1025-1029,共5页
International Journal of Anesthesiology and Resuscitation
关键词
右美托咪定
佐剂
头皮神经阻滞
术后镇痛
Dexmedetomidine
Adjuvant
Scalp block
Postoperative analgesia
