Makhni Reena, Attri Joginder Pal, Jain Payal, Chatrath Veena
Department of Anaesthesia, Government Medical College, Amritsar, Punjab, India.
Anesth Essays Res. 2017 Jan-Mar;11(1):206-210. doi: 10.4103/0259-1162.200237.
Postoperative pain is a major cause of fear and anxiety in hospitalized patients and so if patients remain pain-free during this period, they can cooperate with the circumstances well, leading to early recovery. Over the last two decades, there has been considerable revival of interest in the use of regional anesthesia techniques for surgery and pain management. As very few studies have been conducted using ropivacaine with dexmedetomidine and magnesium sulfate (MgSO) as adjuvants, the present study was undertaken with primary aims to compare the hemodynamic stability, onset and duration of sensory and motor block and with secondary aims of the postoperative analgesic effect of dexmedetomidine and MgSO along with ropivacaine.
After getting the Institutional Ethics Committee approval, this study was conducted on fifty patients of the American Society of Anesthesiologists physical Status I and II aged between 20 and 65 years of either sex and scheduled to undergo infraumbilical surgeries under spinal anesthesia. They were divided into two groups of 25 each. Group D patients received 3 ml of 0.75% isobaric ropivacaine hydrochloride with 10 μg of dexmedetomidine whereas Group M patients received 75 mg of MgSO in the place of dexmedetomidine. The quality of surgical analgesia and quality of intraoperative muscle relaxation were assessed and graded.
We found out that onset of sensory and motor block was earlier in Group D in comparison to Group M. There was a significant reduction in the time to the first rescue analgesia in group receiving intrathecal dexmedetomidine.
It is concluded from our study that ropivacaine plus dexmedetomidine group are better than ropivacaine plus MgSO in providing early onset of sensory and motor block as well as in providing postoperative analgesia.
术后疼痛是住院患者恐惧和焦虑的主要原因，因此如果患者在此期间保持无痛状态，他们就能很好地配合各种情况，从而实现早期康复。在过去二十年中，人们对使用区域麻醉技术进行手术和疼痛管理的兴趣大幅复苏。由于使用罗哌卡因联合右美托咪定和硫酸镁（MgSO）作为辅助剂的研究非常少，本研究的主要目的是比较血流动力学稳定性、感觉和运动阻滞的起效时间及持续时间，次要目的是研究右美托咪定和MgSO与罗哌卡因联合使用的术后镇痛效果。
获得机构伦理委员会批准后，本研究对50例年龄在20至65岁之间、美国麻醉医师协会身体状况分级为I级和II级的患者进行，这些患者计划在脊髓麻醉下接受脐下手术。他们被分为两组，每组25人。D组患者接受3毫升0.75%的等比重盐酸罗哌卡因加10微克右美托咪定，而M组患者接受75毫克MgSO代替右美托咪定。评估并分级手术镇痛质量和术中肌肉松弛质量。
我们发现，与M组相比，D组感觉和运动阻滞的起效时间更早。接受鞘内注射右美托咪定的组首次补救镇痛时间显著缩短。
我们的研究得出结论，在提供早期感觉和运动阻滞以及术后镇痛方面，罗哌卡因加右美托咪定组优于罗哌卡因加MgSO组。
