摘要
目的探讨右美托咪定复合罗哌卡因用于胸腔镜术胸椎旁阻滞对患者术后睡眠质量的影响。方法选取医院2019年4月至2020年8月收治的非心脏手术患者160例,按随机数字表法分为A组(54例)、B组(53例)、C组(53例)。3组患者均行超声引导胸椎旁神经阻滞,A组患者经导管注入盐酸右美托咪定注射液,B组患者经导管注入盐酸罗哌卡因注射液,C组患者联用A组和B组用药方案。结果C组患者围术期的丙泊酚用量显著少于A组和B组(P<0.05)。与术后2 h比较,3组患者术后4,8 h的视觉模拟量表(VAS)评分均显著升高;与术后8 h比较,3组患者术后12 h VAS评分均显著降低,且C组均显著低于A组和B组(P<0.05)。与术后1 d比较,3组患者术后2 d的匹兹堡睡眠质量指数各项评分均显著降低,且C组显著低于A组和B组(P<0.05)。3组患者术后1 d的5-羟色胺(5-HT)、白细胞介素1(IL-1)、白细胞介素6、肿瘤坏死因子-α水平均显著升高,且C组患者均显著低于A组和B组(P<0.05)。3组患者恶心呕吐、心动过缓、呼吸抑制、补救镇痛发生率均无显著差异(P>0.05)。结论右美托咪啶复合罗哌卡因用于胸腔镜术胸椎旁阻滞,有利于减少术中丙泊酚用量,可下调5-HT,IL-1等血清学指标,减轻疼痛,改善睡眠质量。
Objective To investigate the effect of dexmedetomidine combined with ropivacaine on the postoperative sleep quality in patients undergoing thoracoscopy-guided thoracic paravertebral block.Methods A total of 160 patients underwent non-cardiac surgery admitted to the hospital from April 2019 to August 2020 were selected and divided into the group A(54 cases),group B(53 cases)and group C(53 cases)by the random number table method.Patients in the three groups underwent the ultrasound-guided thoracic paravertebral nerve block.Patients in the group A were given Dexmedetomidine Hydrochloride Injection via catheter,patients the group B were given Ropivacaine Hydrochloride Injection via catheter,and patients in the group C were given a combination of the above two treatment regimens.Results The dosage of propofol during perioperative period in the group C was significantly less than that in the groups A and B(P<0.05).Compared with that at 2 h after surgery,the Visual Analogue Scale(VAS)score in the three groups at 4,8 h after surgery was significantly higher.Compared with that at 8 h after surgery,the VAS score in the three groups at 12 h after surgery was significantly lower,and that in the group C was significantly lower than that in the groups A and B(P<0.05).Compared with that on the first day after surgery,the score of each item of Pittsburgh Sleep Quality Index(PSQI)in the three groups was significantly lower on the second day after surgery,and that in the group C was significantly lower than that in the groups A and B(P<005).Compared with those before surgery,the levels of 5-hydroxytryptamine(5-HT),interleukin-1(IL-1),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the three groups on the first day after surgery were abnormally higher,and those in the group C were significantly lower than those in the groups A and B(P<0.05).There was no significant difference in the incidence of nausea,vomiting,bradycardia,respiratory depression and rescue analgesia among the three groups(P>0.05).Conclusion Dexmedetomidin
作者
史炯
王新波
李建华
吕航宇
侯保科
陈永学
SHI Jiong;WANG Xinbo;LI Jianhua;LYU Hangyu;HOU Baoke;CHEN Yongxue(Handan Central Hospital,Handan,Hebei,China 065001)
出处
《中国药业》
CAS
2023年第12期101-104,共4页
China Pharmaceuticals
基金
2019年度河北省医学科学研究课题[20191850]。
