【摘要】 目的 探讨胸科手术患者术后以超声引导椎旁神经阻滞罗哌卡因、右美托咪定复合麻醉的镇痛效果。方法随机选择2019年9月—2021年3月于该院接受胸科手术治疗的患者80例，均实施超声引导椎旁神经阻滞麻醉，根据所选择麻醉药物不同进行分组，对照组（n=40）单纯采用罗哌卡因麻醉及术后镇痛，观察组（n=40）采用罗哌卡因复合右美托咪定麻醉及术后镇痛，比较两组患者术后不同时间镇痛效果及镇静评分、不良反应总发生率。结果 两组患者术后拔管即刻疼痛评分、镇静评分差异无统计学意义（P>0.05），观察组患者术后4 h疼痛评分（2.12±0.25）分、12 h疼痛评分（2.68±0.17）分、24 h疼痛评分（2.86±0.19）分、48 h疼痛评分（3.13±0.42）分均低于对照组，差异有统计学意义（t=16.570、34.230、30.206、14.941,P<0.05），观察组镇静评分高于对照组，差异有统计学意义（P<0.05）。两组患者不良反应总发生率差异无统计学意义（P>0.05）。结论 胸科手术患者采取罗哌卡因、右美托咪定超声引导椎旁神经阻滞麻醉及术后镇痛具有确切效果，能够有效提高镇静质量，减轻患者痛感，同时安全性高，提倡运用且推广。更多还原

【Abstract】 Objective To investigate the analgesic effect of combined anesthesia with ropivacaine and dexmedetomidine by ultrasound-guided paravertebral nerve block in patients undergoing thoracic surgery. Methods A total of 80patients who received thoracic surgery in the hospital from September 2019 to March 2021 were randomly selected,all of them underwent ultrasound-guided paravertebral nerve block anesthesia, and were divided into groups according to the selected anesthetic drugs. The control group(n=40) was treated with ropivacaine anesthesia and postoperative analgesia, the observation group(n=40) was treated with ropivacaine combined with dexmedetomidine anesthesia and postoperative analgesia. The postoperative analgesia effect, sedation score, and total incidence of adverse reactions were compared between the two groups. Results There was no statistically significant difference in the pain score and sedation score immediately after extubation between the two groups(P>0.05); the postoperative pain scores of the observation group 4 h(2.12±0.25) points, 12 h(2.68±0.17) points, 24 h(2.86±0.19) points and 48 h(3.13 ±0.42) points were lower than those of the control group, and the difference was statistically significant(t =16.570,34.230, 30.206, 14.941, P <0.05), the sedation score of the observation group was higher than that of the control group, the difference was statistically significant(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05). Conclusion Ropivacaine and dexmedetomidine ultrasound-guided paravertebral nerve block anesthesia and postoperative analgesia for thoracic surgery patients have definite effects. It can effectively improve the quality of sedation and reduce the pain of patients. At the same time,the safety is high, and the use and promotion are encouraged.更多还原