摘要
目的探究在手术治疗糖尿病足患者下肢神经阻滞中应用右美托咪定复合罗哌卡因的效果。方法筛选该院2019年5月-2020年5月收治的102例糖尿病足患者纳入研究,所有患者均择期实施糖尿病足扩创手术治疗,手术治疗均于超声引导下行腘窝坐骨神经并隐神经阻滞麻醉,根据麻醉用药的差异性将其分为对照组(n=51,予以0.33%罗哌卡因)与观察组(n=51,0.33%罗哌卡因复合右美托咪定0.5μg/kg),观察两组患者术中应用效果及术后镇痛效果。结果观察组患者术中收缩压、舒张压、心率以及平均动脉压最高值及最低值均相较对照组更优,差异有统计学意义(P<0.05),两组血清皮质醇最高值及最低值相较差异无统计学意义(P>0.05);术前,两组患者运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)相较差异无统计学意义(P>0.05);术后24 h,两组患者MNCV、SNCV相较术前有所改善,但组间相较对照组改善幅度明显小于改善组,差异有统计学意义(P<0.05);术后观察组2、12、24、48 h静息、活动时NRS评分均较对照组更优,差异有统计学意义(P<0.05);观察组麻醉不良反应发生率3.92%较对照组21.57%更低,差异有统计学意义(P<0.05)。结论在实施手术治疗的糖尿病足患者中予以超声引导下腘窝坐骨神经并隐神经阻滞复合麻醉应用效果显著,相较于单一麻醉而言更利于术中控制机体各项生命体征的平稳性,患者术后镇痛效果良好,睡眠质量不会受到影响,同时还能避免发生麻醉不良反应,值得临床进行大力推广。
Objective To explore the effect of dexmedetomidine combined with ropivacaine in surgical treatment of lower limb nerve block in patients with diabetic foot.Methods A total of 102 diabetic foot patients admitted to the hospital from May 2019 to May 2020 were selected and included in the study.All patients underwent elective surgical treatment of diabetic foot.The surgical treatment was performed under ultrasound guidance of the popliteal sciatic nerve and saphenous nerve block anesthesia,according to the difference of anesthesia drugs,they were divided into a control group(n=51,0.33%ropivacaine)and an observation group(n=51,0.33%ropivacaine combined with dexmedetomidine 0.5μg/kg),observed the effect of intraoperative application and postoperative analgesia in the two groups of patients.Results The highest and lowest values of intraoperative systolic blood pressure,diastolic blood pressure,heart rate,and mean arterial pressure in the observation group were better than those in the control group,the difference was statistically significant(P<0.05).There was no significant difference between the highest and lowest values of serum cortisol between the two groups(P>0.05).Before surgery,there was no statistically significant difference in motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)between the two groups(P>0.05);24 h after the operation,the two groups of patients had MNCV,SNCV was better than that before surgery,but comparison between the groups,the reducation of control group was significantly smaller than that of the observation group,the difference was statistically significant(P<0.05).The NRS scores of the observation group at 2 h,12 h,24 h and 48 h were higher than those of the control group,the difference was statistically significant(P<0.05).The incidence of adverse anesthesia reactions in the observation group was 3.92%lower than that of the control group 21.57%,the difference was statistically significant(P<0.05).Conclusion Ultrasound-guided popliteal sciatic nerve and saphe
作者
任燕
曾朝阳
REN Yan;ZENG Chaoyang(Department of Anesthesiology,Chongqing Iron and Steel General Hospital,Chongqing,404100 China)
出处
《糖尿病新世界》
2021年第7期94-97,102,共5页
Diabetes New World Magazine
关键词
手术治疗
下肢神经阻滞
右美托咪定
罗哌卡因
复合麻醉
Surgical treatment
Lower limb nerve block
Dexmedetomidine
Ropivacaine
Combined anesthesia
