临床误诊误治2018，Vol.31Issue(7)：29-33,5.DOI:10.3969/j.issn.1002-3429.2018.07.008
右美托咪定联合罗哌卡因TPVB在单侧开胸手术中麻醉及术后镇痛效果研究
Effect of Dexmedetomidine Combined with Ropivacaine on Thoracic Paravertebral Nerve Block after Unilateral Thoracotomy and the Satisfaction of Analgesia
摘要
Abstract
Objective To investigate the effect of dexmedetomidine combined with ropivacaine on thoracic paravertebral nerve block ( TPVB) after unilateral thoracotomy and the satisfaction of analgesia. Methods A total of 87 patients who underwent unilateral thoracotomy in our hospital from January 2016 to March 2017 were randomly di-vided into the observation group ( n ＝47) and the control group ( n ＝40 ) , according to alternate medical record number. The control group was treated with 30 ml 0. 35% ropivacaine for TPVB, whereas the observation group was treated with 1 μg/kg dexmedetomidine injection+30 ml 0. 35% ropivacaine for TPVB. The effect of paravertebral block,recovery time, the hemodynamic changes at different time points [ at the time of sedation after entering operat- ing room( T0) , at 15 min after thoracic paravetebral injection ( T1) , immediately after tracheal intubation ( T2) , 5 min after skin incision ( T3) and before postoperative extubation( T4) ] , visual analogue score( VAS) at 6, 12, 24, and 48 h after surgery and adverse reactions were recorded and compared between the two groups. Results There were no significant differences between the two groups regarding the onset time of vertebral block, the fixation time of the block plane, and recovery time (P>0. 05). Compared with the control group, mean arterial pressure (MAP) and heart rate ( HR) in T1-T4 in the observation group were decreased significantly ( P<0. 05) . Changes of MAP and HR levels in T1-T4 showed no significantly differences in observation group ( P>0. 05) , whereas those in T2-T4 in control group ( P<0. 05) . The VAS scores at 6, 12, 24 and 48 h after surgery were significantly lower in the observation group than in the control group ( P<0. 05) . Conclusion The effect of dexmedetomidine com-bined with ropivacaine on TPVB after unilateral thoracotomy was preferable, and postoperative analgesia was satisfac-tory. It helps to maintain the hemodynamic stability of the body, with minimal adverse reactions. Thus, it is worthy of clinical application.关键词
胸椎旁神经阻滞/右美托咪定/罗哌卡因/麻醉和镇痛Key words
Thoracic paravertebral nerve block/Dexmedetomidine/Ropivacaine/Anesthesia and analgesia分类
医药卫生引用本文复制引用
王福刚,彭毅,王学然,卢建波,魏智慧,王志存..右美托咪定联合罗哌卡因TPVB在单侧开胸手术中麻醉及术后镇痛效果研究[J].临床误诊误治,2018,31(7):29-33,5.基金项目
河北省科学技术发展基金项目(20170077) （20170077）
