摘要
目的探讨地塞米松复合右美托咪定肋间神经阻滞方案对胸腔镜肺切除术患者术后镇痛效果及炎性反应的影响。方法选取2018年3月至2019年4月我院行胸腔镜肺切除术的100例患者为研究对象,采用随机数字表法分为4组(对照组、地塞米松组、右美托咪定组、联合用药组),每组25例,对比不同肋间神经阻滞方案的镇痛效果及对炎性反应的影响。结果联合用药组(罗哌卡因+地塞米松+右美托咪定)镇痛时间长于其他组,芬太尼用量低于其他组(P均<0.05)。联合用药组VAS评分均低于其他组别(P均<0.05)。联合用药组血清炎性因子IL-6、CRP水平均低于对照组、地塞米松组和右美托咪定组(P均<0.05)。4组患者术后不良反应发生率比较差异无统计学意义(P>0.05)。结论罗哌卡因联合地塞米松和右美托咪定可延长胸腔镜肺切除术患者肋间神经阻滞麻醉的术后镇痛时间,减少芬太尼用量,减轻患者疼痛程度,降低炎症反应。
Objective To investigate the effect of dexamethasone combined with dexmedetomidine on postoperative analgesia and inflammatory response in patients undergoing thoracoscopic pneumonectomy.Methods A total of 100 patients underwent thoracoscopic pneumonectomy in our hospital from March 2018 to April 2019 were selected as the study subjects and randomly divided into 4 groups(control group,dexamethasone group,dexamethasone group,combination group),25 cases in each group. The analgesic effect of different intercostal nerve block schemes and their effects on inflammatory response were compared. Results The analgesic time of the combined group(rop ivacaine+dexamethasone+dextromethomidine)was longer than that of other groups,and the dosage of fentanyl was lower than that of other groups(P all<0.05). The VAS score of the combined group was lower than that of other groups(P all<0.05). Compared with pre-operation,the levels of IL-6 and CRP in the combined group were lower than those in other groups(P all<0.05). There was no significant difference in the incidence of postoperative adverse reactions among the four groups(P>0.05). Conclusion In patients undergoing thoracoscopic pneumonectomy,the use of ropivacaine combined with dexamethasone and dexmedetomidine for intercostal nerve block can prolong the time of postoperative analgesia,reduce the dosage of fentanyl,alleviate the degree of pain and reduce inflammation.
作者
朱腾飞
王娜
ZHU Tengfei;WANG Na(Department of Anesthesiology,Changzheng Hospital of Second Military Medical University,Shanghai200003,China)
出处
《宁夏医科大学学报》
2020年第6期606-609,共4页
Journal of Ningxia Medical University
关键词
地塞米松
右美托咪定
胸腔镜手术
镇痛
dexamethasone
dexmedetomidine
thoracoscopic surgery
analgesia
