| 右美托咪定对低浓度罗哌卡因股神经阻滞的影响 |
| 投稿时间：2017-10-28 修订日期：2017-11-17 点此下载全文 |
| 引用本文：张亮光,李泉.右美托咪定对低浓度罗哌卡因股神经阻滞的影响[J].医学研究杂志,2018,47(8):167-171 |
| DOI：
10.11969/j.issn.1673-548X.2018.08.039 |
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| 中文摘要:目的 观察比较右美托咪定（Dex）复合低浓度罗派卡因（Rop）股神经阻滞对前交叉韧带重建（ACLR）患者术后镇痛效果及肌力的影响。方法 全身麻醉下行ACLR患者60例，采用数字表法随机分为观察组（A组，n=30）和对照组（B组，n=30）。A组以0.125% Rop 20ml+Dex 25μg超声引导下股神经阻滞，B组以0.25% Rop 20ml超声引导下股神经阻滞。分别用视觉模拟评分法（VAS）及徒手肌力法评估两组患者术后不同时间点（4、8、12、18、24h）疼痛程度及股四头肌肌力。记录两组患者术后镇痛药补救情况，恶心、呕吐、心动过缓等不良反应。结果 两组患者VAS评分：术后4、8、24h相似（P>0.05），术后12、18h观察组低于对照组（P<0.05）；追加镇痛药患者两组例数相似（P>0.05），A组追加镇痛药用量低于B组（P<0.05）。术后4、12、18、24h两组肌力相似（P>0.05），术后8h观察组患者股四头肌肌力高于对照组（P<0.05）。观察组发生恶心、呕吐3例，对照组5例，观察组心动过缓2例。两组患者术后恶心、呕吐、心动过缓等不良反应发生率相似（P>0.05）。结论 右美托咪定能减少局部麻醉药术后镇痛浓度。与单纯Rop比较，Dex复合低浓度Rop股神经阻滞，能为ACLR患者提供相似的镇痛，作用时间更长，且对股四头肌肌力影响小。 |
| 中文关键词:股神经阻滞 右美托咪定 前交叉韧带重建 术后镇痛 |
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| Effect of Dexmedetomidine on Low-ropivacaine for Femoral Nerve Block |
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| Abstract:Objective To observe and compare the effect of dexamethasone (Dex) combined with low-concentration ropivacaine (Rop) femoral nerve block on the postoperative analgesia and muscle strength of patients with anterior cruciate ligament reconstruction (ACLR). Methods Sixty ACLR patients undergoing general anesthesia were randomly divided into the observation group (group A, n=30) and the control group (group B, n=30). Group A underwent ultrasound-guided femoral nerve block with 0.125% Rop 20ml+Dex 25μg, while group B underwent ultrasound-guided femoral nerve block with 0.25% Rop20ml. We assessed the pain degree and quadriceps femoris muscle strength at different time point of 4h, 8h, 12h, 18h, 24h after operation by the methods of visual analogue scale (VAS) and manual muscle testing method respectively. We recorded the postoperative analgesics remedy, and nausea, vomiting, bradycardia and other adverse events in the two groups. Results The VAS score of the observation group was similar to that of control group at 4, 8 and 24h after operation(P<0.05), but lower than that of control group at 12 and 18h after operation (P>0.05). The number of patients used analgesics in the two groups was similar (P>0.05), but the amount of analgesic in group A was lower than that in group B (P<0.05). The muscle strength of the two groups was similar at 4, 12, 18 and 24h after operation (P>0.05), but the quadriceps femoris muscle strength of observation group was higher than that of control group after 8h operation (P<0.05). 3 patients in the observation group and 5 patients in control group had nausea and vomiting, and 2 patients had intraoperative bradycardia. The incidence of adverse reactions such as nausea, vomiting and bradycardia was similar in both groups (P>0.05). Conclusion Dex reduced the postoperative analgesic concentration.Compared with Rop alone, Dex combined with low concentration of Rop femoral nerve block can provide similar analgesia for ACLR patients and has little effect on quadriceps femoris muscle strength. |
| keywords:Femoral nerve block Dexmedetomidine Anterior cruciate ligament reconstruction Postoperative analgesia |
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