摘要
Abstract
Objective:To compare the different doses of dexmedetomidine(DEX)combined with ropivacaine on the effect of pediatric caudal block,and determine the suitable dosage of DEX.Method:Sixty children(ASAⅠ)aged 1-7 years scheduled for elective inguinal hernia repair or orchidopexy were randomly randomly divided into the group R,the group RD1 and the group RD2,20 cases in each group.The group R received a caudal injection of 0.25%ropivacaine 1 ml/kg,the group RD1 received the same dose of ropivacaine mixed with DEX 1μg/kg,and the group RD2 mixed with DEX 2 μg/kg.The end-tidal sevoflurane concentration(ET-sevo),emergence behavior state score,incidence of emergence agitation(EA),postoperative sedation score,duration of postoperative analgesia,the proportion of requirement for additional analgesics,quality of sleep,recovery from anesthesia and postoperative complications among the three groups were observed and compared.Result:The ET-sevo,emergence behavior state score,incidence of EA and the proportion of requirement for additional analgesics were significantly lower,the quality of sleep was significantly better,the postoperative sedation score was significantly higher and the duration of postoperative analgesia was significantly longer in Group RD1 and Group RD2 compared with Group R,the differences were statistically significant (P<0.05 or P<0.01).Compared to Group RD1,the ET-sevo,emergence behavior state score,duration of postoperative analgesia and the proportion of requirement for additional analgesics in Group RD2 had statistically significant differences too(P<0.05).But recovery from anesthesia and postoperative complications had no statistically significant difference in all groups(P>0.05).Conclusion:Addition of DEX 1 or 2μg/kg to 0.25%ropivacaine(1 mL/kg)can significantly improve the efficacy of pediatric caudal block,reduce sevoflurane requirements and the incidence of EA,maintain moderate sedation during the early post-operative period,improve the quality of sleep,significantly prolong the duration of postoperative analgesia,but don’t affect the recovery and increase the complications of anesthesia.Compared to addition of DEX 1μg/kg,2μg/kg not only has same security but better efficacy.关键词
右美托咪定/罗哌卡因/骶管阻滞/小儿Key words
Dexmedetomidine/Ropivacaine/Caudal block/Pediatric
