鞘内注射右美托咪定或可乐定联合布比卡因对接受下肢手术的创伤患者的镇痛效果:一项随机双盲研究。

The analgesic effect of intrathecal dexmedetomidine or clonidine, with bupivacaine, in trauma patients undergoing lower limb surgery: a randomised, double-blind study.

作者信息

Solanki S L, Bharti N, Batra Y K, Jain A, Kumar P, Nikhar S A

机构信息

Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Anaesth Intensive Care. 2013 Jan;41(1):51-6. doi: 10.1177/0310057X1304100110.

Abstract

This randomised, double-blind study was designed to compare the duration of analgesia and adverse effects following intrathecal administration of dexmedetomidine or clonidine, both with bupivacaine, in trauma patients. Ninety adult trauma patients of American Society of Anesthesiologists physical status I-II, scheduled for lower limb surgery under subarachnoid block, were randomly allocated to one of three groups. All groups received hyperbaric bupivacaine 0.5% 3 ml, to which was added saline 0.5 ml (Group B): clonidine 50 µg (Group C) or dexmedetomidine 5 µg (Group D). The onset and duration of sensory and motor blockade, severity of postoperative pain, time to first rescue analgesia and total analgesic requirement for 24 hours were noted. There was no significant difference in the onset time of the block but the duration of sensory and motor blockade was prolonged in Groups C and D, compared with Group B. The time to analgesia was significantly prolonged in Group D (824±244 minutes) compared with Group C (678±178 minutes; P=0.01), the latter being longer than Group B (406±119 minutes; P=0.0001). Postoperative pain scores were lower in Groups C and D compared with group b. The requirement for rescue analgesia during the first 24 postoperative hours was significantly less in Groups C and D as compared to Group B (P=0.0001), but comparable between Groups C and D (P=0.203). In conclusion, dexmedetomidine 5 µg added to intrathecal bupivacaine 15 mg produces longer postoperative analgesia than clonidine 50 µg among trauma patients undergoing lower limb surgery.

摘要

这项随机、双盲研究旨在比较在创伤患者中鞘内注射右美托咪定或可乐定(均与布比卡因合用)后的镇痛持续时间和不良反应。90例美国麻醉医师协会身体状况为I-II级、计划在蛛网膜下腔阻滞下行下肢手术的成年创伤患者,被随机分为三组。所有组均接受3 ml 0.5%的重比重布比卡因,并加入0.5 ml生理盐水(B组);50 μg可乐定(C组)或5 μg右美托咪定(D组)。记录感觉和运动阻滞的起效时间和持续时间、术后疼痛的严重程度、首次补救镇痛的时间以及24小时的总镇痛需求量。阻滞的起效时间无显著差异,但与B组相比,C组和D组的感觉和运动阻滞持续时间延长。与C组(678±178分钟;P=0.01)相比,D组(824±244分钟)的镇痛时间显著延长,C组比B组(406±119分钟;P=0.0001)长。与B组相比,C组和D组的术后疼痛评分较低。与B组相比,C组和D组术后24小时内的补救镇痛需求量显著减少(P=0.0001),但C组和D组之间相当(P=0.203)。总之,在接受下肢手术的创伤患者中,向15 mg鞘内布比卡因中添加5 μg右美托咪定比添加50 μg可乐定产生的术后镇痛时间更长。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索