贾长新 1王青 1潘黎晓 1郝诗苑 1李玲玉 1王士雷1
作者信息
- 1. 青岛大学附属医院麻醉科,山东青岛266003
- 折叠
摘要
Abstract
Objective To evaluate the effectiveness of using dexmedetomidine combined with ropivacaine in epidural anesthesia for total knee replacement (TKR).Methods A total of 100 patients with single TKR were selected,and equally randomized to two groups as dexmedetomidine group (DEX group) and control group.Applying 15 mL of miscible liquids-dexmedetomidine 0.5 μg/kg and 5 g/L ropivacaine-for epidural anesthesia in patients of DEX group,and those in the control group were given 15 mL of 5 g/L ropivacaine for epidural anesthesia.Postoperatively,an analgesia pump was used for analgesia,the compositions of analgesic liquid were sufentanil 2 μg/kg+tropisetron 5 mg+saline diluted to 100 mL.Background dose was 2 mL/h,patient controlled analgesia (PCA) was 2 mL and PCA interval was 15 min.The following items were compared between the two groups:the time of full anesthesia (T1),anesthesia maintenance time (T2),intra operative Remasy sedation score,mean arterial pressure (MAP) 3 minutes after the tourniquet was released,pain degree 48 h after surgery (VAS score),the pressure time of PCA in 48 h after surgery and adverse reactions.Results Compared with the control group,T1 in DEX group was shorter and T2 was longer (u =-8.537,-8.162;P＜0.05).No sedation medications were used intra-operation in both groups,patients in the control group all kept awake,with sedation score of 1-2 marks;the patients in DEX group appeared phenomenon of sleepiness 20minutes after epidural medication but response to call,with Remasy sedation score of 3-4.At three minutes after the tourniquet was released,fluctuation range of blood pressure of patients in the two groups was large,but the differences were not statistically significant (P ＞0.05).Compared with the control group,the VAS score of patients in DEX group was lower-3,6,12 and 24 h after surgery (u =-9.950--7.384,P ＜0.05),while the difference in VAS score-48 h after surgery-between the two groups was not significant (P＞0.05).The PCA pressure times within 24 h after surgery in DEX group was less than that in the control group (u =-7.489,P＜0.05).The differences in adverse reactions between the two groups were not statistically isgnificant (P＞0.05).Conclusion Epidural administration of Dexmedetomidine can shorten the onset time of ropivacaine,and prolong its maintenance time with a good postoperative analgesic effect.关键词
右美托咪啶/关节成形术,置换,膝/麻醉,硬膜外Key words
dexmedetomidine/arthroplasty, replacement, knee/ancsthcsia, cpidural分类
医药卫生
