右美托咪定作为鞘内辅助用药用于术后镇痛。
Dexmedetomidine as an intrathecal adjuvant for postoperative analgesia.
作者信息
Gupta Rajni, Bogra Jaishri, Verma Reetu, Kohli Monica, Kushwaha Jitendra Kumar, Kumar Sanjiv
机构信息
Department of Anaesthesia, Chhatrapati Shahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India.
出版信息
Indian J Anaesth. 2011 Jul;55(4):347-51. doi: 10.4103/0019-5049.84841.
BACKGROUND
Spinal anaesthesia is the most common approach which is used for lower limb surgery. Dexmedetomidine is the recent drug which acts on α2-adrenergic receptors in the dorsal horn of the spinal cord to produce analgesic effects.
AIM
Efficacy and safety of intrathecal dexmedetomidine added to ropivacaine.
SETTING AND DESIGN
Randomised double blind trial.
METHODS
Sixty patients were randomly allocated to receive intrathecally either 3 ml of 0.75% isobaric ropivacaine + 0.5 ml normal saline (Group R) or 3 ml of 0.75% isobaric ropivacaine + 5 μg dexmedetomidine in 0.5 ml of normal saline (Group D).
RESULTS
The mean time of sensory regression to S2 was 468.3±36.78 minutes in group D and 239.33±16.8 minutes in group R. Duration of analgesia (time to requirement of first rescue analgesic) was significantly prolonged in group D (478.4±20.9 minutes) as compared to group R (241.67±21.67 minutes). The maximum visual analogue scale score for pain was less in group D (4.4±1.4) as compared to group R (6.8±2.2).
CONCLUSION
The addition of dexmedetomidine to ropivacaine intrathecally produces a prolongation in the duration of the motor and sensory block.
背景
脊髓麻醉是下肢手术最常用的方法。右美托咪定是一种新型药物，作用于脊髓背角的α2肾上腺素能受体产生镇痛效果。
目的
鞘内注射右美托咪定联合罗哌卡因的有效性和安全性。
设置与设计
随机双盲试验。
方法
60例患者随机分为两组，分别鞘内注射3 ml 0.75%等比重罗哌卡因+0.5 ml生理盐水（R组）或3 ml 0.75%等比重罗哌卡因+5 μg右美托咪定溶于0.5 ml生理盐水中（D组）。
结果
D组感觉阻滞消退至S2的平均时间为468.3±36.78分钟，R组为239.33±16.8分钟。与R组（241.67±21.67分钟）相比，D组镇痛持续时间（至首次需要补救镇痛的时间）显著延长（478.4±20.9分钟）。D组疼痛的最大视觉模拟评分（4.4±1.4）低于R组（6.8±2.2）。
结论
鞘内注射罗哌卡因时添加右美托咪定可延长运动和感觉阻滞的持续时间。
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