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右美托咪定对小儿罗哌卡因骶管阻滞效应的影响
The Influence of Dexmedetomidine on the Effect of Caudal Block with Ropivacaine in Children
【作者】 范文杰;
【导师】 王士雷;
【作者基本信息】 青岛大学 , 麻醉学, 2012, 硕士
【摘要】 目的研究右美托咪定对小儿骶管阻滞效应的影响。方法选择60例1-6岁(ASA I)拟行腹股沟斜疝或鞘膜积液手术的患儿,随机分为两组(n=30):R组骶管注入0.25%罗哌卡因lml/kg;RD组骶管注入0.25%罗哌卡因lml/kg+右美托咪定1μ g/kg。监测术中心率(HR)、呼吸(RR)、血压(BP)和脉搏氧饱和度(SpO2),记录骶管阻滞起效时间;患儿苏醒时间;镇痛药应用时间,采用Ramsay评分判定患儿苏醒和躁动,用FLACC量表评估患儿术后疼痛。结果两组患儿月龄、体重、手术时间,阻滞起效时间无显著差异。与R组比较RD组苏醒时间延长,苏醒后躁动减少,镇痛药应用减少,镇痛时间延长(P<0.05)。结论1u g/kg右美托咪定可增强小儿罗哌卡因骶管阻滞的效果。
【Abstract】 Objective To investigate the influence of dexmedetomidine on the caudal block with ropivacaine in children.Methods60patients suffering from indirect inguinal hernia or hydrocele of tunica vaginalis and aged1-6years were enrolled in our study. They were divided into two groups randomly to receive0.25%ropivacaine lmg/kg (group R) and0.25%ropivacaine lmg/kg and dexmedetomidine1μg/kg (group RD). The intra-operative heart rate(HR), respiratory rate(RR), tidal volume(TV), blood pressure(BP) and SpO2were normally monitored. The time of the onset of caudal block, the recovery of consciousness and the administration of analgesics were recorded. We select the Ramsay score to estimate the recovery from anesthesia and post-operative agitation and the FLACC Pain Assessment Tool to assess post-operative pain.Results The age, weight, duration of operation and the onset of caudal block were comparable (p>0.05). Group RD displayed The recovery time were increased, post-operative agitation and the overall dose of analgesics of group RD were reduced in comparison with group R, while group RD displayed a markedly prolonged antalgic duration(p<0.05).Conclusions Dexmedetomidine (1μg/kg) can enhance the effect of ropivacaine for the caudal block in children.