| 谢玉琼,郑俊奕,蔡淑玲,李廷芳,刘美燕.不同浓度罗哌卡因复合右美托咪定在肛肠疾病日间手术中的麻醉效果研究[J].,2019,19(13):2506-2510 |
| 不同浓度罗哌卡因复合右美托咪定在肛肠疾病日间手术中的麻醉效果研究 |
| Anesthetic Effect of Different Concentration of Ropivacaine Combined with Dexmedetomidine on Anorectal Diseases During Day Surgery |
| 投稿时间：2018-12-18 修订日期：2019-01-15 |
| DOI：10.13241/j.cnki.pmb.2019.13.024 |
| 中文关键词: 不同浓度 罗哌卡因 右美托咪定 肛肠疾病 麻醉效果 |
| 英文关键词: Different concentration Ropivacaine Dexmedetomidine Anorectal diseases Anesthetic effect |
| 基金项目:广东省中医药局科研项目（20152115） |
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| 中文摘要: |
| 摘要 目的：研究不同浓度罗哌卡因复合右美托咪定在肛肠疾病日间手术中的麻醉效果。方法：选取2016年5月~2018年5月期间于我院行肛肠疾病日间手术的患者123例为研究对象。根据随机数字表将患者分成A、B、C三组，每组各41例，其中A组麻醉时注入右美托咪定复合0.375%罗哌卡因20 mL，B组麻醉时注入右美托咪定复合0.5%罗哌卡因20 mL，C组注入右美托咪定复合0.75%罗哌卡因20 mL。比较三组患者麻醉后镇痛效果，比较三组麻醉前、麻醉30 min后的呼吸循环指标，比较三组患者感觉神经、运动神经阻滞情况，记录三组患者术后不良反应发生情况。结果：B组、C组镇痛优良率显著高于A组（P<0.05），但B组、C组镇痛优良率组间比较差异无统计学意义（P>0.05）。三组患者麻醉前、麻醉30 min后心率（HR）、收缩压（SBP）、舒张压（DBP）、血氧饱和度（SPO2）整体比较差异均无统计学意义（P>0.05）。B组、C组感觉神经阻滞起效时间均较A组短，且C组短于B组（P<0.05），而B组、C组感觉神经阻滞持续时间均较长，且C组长于B组（P<0.05）；B组、C组Bromage评分1分人数均较A组少，且C组少于B组（P<0.05），B组、C组Bromage评分2分人数均较A组多，但C组较B组少（P<0.05），C组Bromage评分3分人数较A组和B组多（P<0.05），三组Bromage评分4分人数整体比较差异均无统计学意义（P>0.05）。C组患者术后不良反应总发生率高于A组、B组（P<0.05），但A组、B组不良反应总发生率组间比较差异无统计学意义（P>0.05）。结论：0.5%、0.75%罗哌卡因复合右美托咪定应用于肛肠疾病日间手术的镇痛效果、麻醉效果优于0.375%罗哌卡因复合右美托咪定，但是0.75%罗哌卡因复合右美托咪定的不良反应发生率偏高，0.5%罗哌卡因复合右美托咪定是肛肠疾病日间手术中更为合适的麻醉方案。 |
| 英文摘要: |
| ABSTRACT Objective: To study the anesthetic effect of different concentration of ropivacaine combined with dexmedetomidine on anorectal diseases during day surgery. Methods: A total of 123 patients with anorectal diseases, who underwent daytime operation in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from May 2016 to May 2018, were selected and were randomly divided into group A, B and C(41 patients in each group). Group A was received dexmedetomidine with 0.375% ropivacaine 20 mL,group B, dexmedetomidine with 0.5% ropivacaine 20 mL, and group C, dexmedetomidine with 0.75% ropivacaine 20 mL. The analgesic effect after anesthesia was compared among the three groups. The respiratory and circulatory indexes before and 30 minutes after anesthesia were compared among the three groups. The blockade of sensory and motor nerves in the three groups were compared. Postoperative adverse reactions were recorded among the three groups. Results: The analgesia excellent and good rate of group B and group C was significantly higher than that of group A (P<0.05), but there was no significant difference in the analgesia excellent and good rate between group B and group C (P>0.05). There were no significant differences in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and blood oxygen saturation (SPO2) among the three groups before and 30 minutes after anesthesia (P>0.05). The onset time of sensory nerve block in group B and C was shorter than that in group A, and group C was shorter than that in group B (P<0.05). The duration of sensory nerve block was longer in group B and C, and the group C was longer than the group B (P<0.05). The number of Bromage score 1 in group B and C were less than those in group A, and group C was less than group B (P<0.05). The number of Bromage score 2 in group B and C were more than those in group A, but the group C was less than the group B (P<0.05). The number of Bromage score 3 in group C were more than those in group A and group B (P<0.05). There were no significant differences in the number of Bromage score 4 among the three groups (P>0.05). The total incidence of adverse reactions in group C was higher than that in group A and group B (P<0.05), but there was no significant difference in the total incidence of adverse reactions between group A and group B (P>0.05). Conclusion: 0.5% and 0.75% ropivacaine combined with dexmedetomidine are better than 0.375% ropivacaine combined with dexmedetomidine for anorectal diseases during day surgery, but the incidence of adverse reactions of 0.75% ropivacaine combined with dexmedetomidine are higher. 0.5% ropivacaine combined with dexmedetomidine is a more suitable anesthetic regimen for day operation of anorectal diseases. |
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