Salgado Paula Fialho Saraiva, Sabbag Amália Tieco, Silva Priscila Costa da, Brienze Sergio Luís Aparecido, Dalto Helio Pontes, Módolo Norma Sueli Pinheiro, Braz José Reinaldo Cerqueira, Nascimento Paulo
Hospital de Base da Faculdade de Medicina de São José do Rio Preto, SP.
Rev Assoc Med Bras (1992). 2008 Mar-Apr;54(2):110-5. doi: 10.1590/s0104-42302008000200011.
This study aimed to evaluate clinical characteristics of epidural anesthesia performed with 0.75% ropivacaine associated with dexmedetomidine.
Forty patients scheduled for hernia repair or varicose vein surgeries under epidural anesthesia participated in this study. They were assigned to: Control Group (n = 20), 0.75% ropivacaine, 20 ml (150 mg); and Dexmedetomidine Group (n = 20), 0.75% ropivacaine, 20 ml (150 mg), plus dexmedetomidine, 1 mg x kg-1. The following variables were studied: total analgesic block onset time, upper level of analgesia, analgesic and motor block duration time, intensity of motor block, state of consciousness, hemodynamics, postoperative analgesia and incidence of side-effects.
Epidural dexmedetomidine did not affect onset time or upper level of anesthesia (p > 0.05) however it prolonged sensory and motor block duration time (p < 0.05) and postoperative analgesia (p < 0.05), and also resulted in a more intense motor block, l (p < 0.05). Values of bispectral index were lower in Dexmedetomidine Group (p < 0.05). There was no difference in incidence of hypotension and bradycardia (p > 0.05). Occurrence of side-effects (shivering, vomiting and SpO2 < 90%) was low and similar between groups (p > 0.05).
There is clear synergism between epidural dexmedetomidine and ropivacaine, further this drug association does not bring about additional morbidity.
本研究旨在评估0.75%罗哌卡因联合右美托咪定进行硬膜外麻醉的临床特征。
40例计划在硬膜外麻醉下进行疝气修补术或静脉曲张手术的患者参与了本研究。他们被分为：对照组（n = 20），给予0.75%罗哌卡因20 ml（150 mg）；右美托咪定组（n = 20），给予0.75%罗哌卡因20 ml（150 mg）加右美托咪定1 mg·kg-1。研究了以下变量：总镇痛阻滞起效时间、镇痛上界、镇痛和运动阻滞持续时间、运动阻滞强度、意识状态、血流动力学、术后镇痛及副作用发生率。
硬膜外给予右美托咪定不影响起效时间或麻醉上界（p > 0.05），但延长了感觉和运动阻滞持续时间（p < 0.05）以及术后镇痛时间（p < 0.05），且导致运动阻滞更强烈，l（p < 0.05）。右美托咪定组的脑电双频指数值较低（p < 0.05）。低血压和心动过缓的发生率无差异（p > 0.05）。副作用（寒战、呕吐和SpO2 < 90%）的发生率较低，且两组间相似（p > 0.05）。
硬膜外右美托咪定与罗哌卡因之间存在明显协同作用，此外这种药物联合不会带来额外的发病率。
