【摘要】 目的探讨右美托咪定联合罗哌卡因进行单次股神经阻滞的效果。方法选取2015年10月～2016年10月择期腰麻硬膜外联合麻醉下膝关节镜前交叉韧带重建手术60例,随机分成2组,每组30例。麻醉前行超声联合神经刺激器引导下单次股神经阻滞,R组注射罗哌卡因50 mg+生理盐水共20 ml;RD组为罗哌卡因50 mg+右美托咪定100μg+生理盐水共20 ml。比较2组镇痛持续时间和术后6、8、12、24、36和48 h静息和运动时疼痛视觉模拟评分(Visual Analogue Scale,VAS)。结果 RD组镇痛持续时间(33.8±21.3)h,较R组(9.6±4.3)h长(t=6.098,P=0.000)。术后6、8、12 h静息和运动时VAS评分RD组均低于R组[静息:6 h中位数0(0～2)分vs.0(0～4)分,Z=-2.525,P=0.012;8 h中位数0(0～7)分vs.0(0～7)分,Z=-3.337,P=0.001;12 h中位数0(0～7)分vs.3(0～8)分,Z=-4.692,P=0.000;运动:6 h中位数0(0～2)分vs.0(0～4)分,Z=-2.525,P=0.012;8 h中位数0(0～8)分vs.1(0～8)分,Z=-3.733,P=0.000;12 h中位数0(0～8)分vs.3(0～8)分,Z=-4.772,P=0.000],2组术后36 h差异无显著性(P>0.05)。结论将右美托咪定加入罗哌卡因进行股神经阻滞可以延长术后镇痛持续时间并降低疼痛评分。更多还原

【Abstract】 Objective To investigate the effect of dexmedetomidine combined with ropivacaine on single-time femoral nerve block. Methods Sixty patients scheduled for selective reconstruction of anterior cruciate ligament surgery between October 2015 to October 2016 were divided into two equal groups by randomized double blind design. Patients received femoral nerve block under ultrasound guided and nerve stimulator. In the group R( n = 30),20 ml of ropivacaine( 50 mg) was given,and in the group RD( n =30),20 ml of ropivacaine( 50 mg) mixed with dexmedetomidine( 100 μg) was given. The duration of motor and sensory block time to first rescue analgesia were recorded. We used Visual Analogue Scale( VAS) to evaluate patients’ analgesia effect in 6,8,12,24,36,and 48 h after surgery. Results The duration of analgesia in the group RD [( 33. 8 ± 21. 3) h] was significantly longer than that of the group R [( 9. 6 ± 4. 3) h,t = 6. 098,P = 0. 000]. The VAS scores at 6,8,and 12 h after surgery were lower in the group RD than in the group R [resting condition: 6 h,0( 0-2) vs. 0( 0-4),Z =-2. 525,P = 0. 012; 8 h,0( 0-7) vs. 0( 0-7),Z =-3. 337,P = 0. 001; 12 h,0( 0-7) vs. 3( 0-8),Z =-4. 692,P = 0. 000; motion condition: 6 h,0( 0-2) vs. 0( 0-4),Z =-2. 525,P = 0. 012; 8 h,0( 0-8) vs. 1( 0-8),Z =-3. 733,P = 0. 000; 12 h,0( 0-8) vs. 3( 0-8),Z =-4. 772,P = 0. 000]. The VAS scores at 36 h after surgery were not different between the two groups( P > 0. 05). Conclusion Combined use of dexmedetomidine with ropivacaine for femoral nerve block can reduce pain scores and prolong the analgesia time.更多还原