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胃切除术后在罗哌卡因中添加右美托咪定对超声引导下双侧腹横肌平面阻滞的影响。

Effect of Adding Dexmedetomidine to Ropivacaine on Ultrasound-Guided Dual Transversus Abdominis Plane Block after Gastrectomy.

作者信息

Ding Wengang, Li Wanying, Zeng Xianzhang, Li Jinying, Jiang Jingjing, Guo Changchun, Li Wenzhi

机构信息

Department of Anesthesiology, The Second Affiliated Hospital of Harbin Medical University, 246, Xuefu Road, Harbin, Heilongjiang, 150086, China.

出版信息

J Gastrointest Surg. 2017 Jun;21(6):936-946. doi: 10.1007/s11605-017-3402-5. Epub 2017 Apr 3.

DOI:10.1007/s11605-017-3402-5
PMID:28374183
Abstract

OBJECTIVES

Transversus abdominis plane (TAP) block is an analgesic technique. Adding dexmedetomidine can enhance regional anesthesia. This study's aim was to evaluate whether dexmedetomidine prolonged analgesic time of TAP block after gastrectomy.

METHODS

Patients scheduled for gastrectomy were randomly assigned to receive a TAP block with saline (group S), ropivacaine (group R), or ropivacaine and dexmedetomidine (group RD). Visual analogue scale (VAS) scores, postoperative nausea and vomiting (PONV) scores, sedation scores, tramadol consumption, ropivacaine concentration, and Quality of Recovery Questionnaire 40 (QoR-40) were recorded.

RESULTS

Patients in group R and group RD had lower VAS scores 2, 4, 12, and 24 h after surgery compared with group S (P < 0.05). PONV scores were lower in group R and group RD compared with group S after 2, 12, 24, and 36 h (P < 0.05). Patients in group R and group RD required less tramadol and had better QoR-40 scores than those in group S (P < 0.05). The aforementioned variables and ropivacaine concentrations did not differ between group R and group RD (P > 0.05). Sedation scores were similar between three groups (P > 0.05).

CONCLUSIONS

TAP block can provide analgesia and improve the quality of recovery. Adding dexmedetomidine does not significantly improve the quality or duration of TAP block.

摘要

目的

腹横肌平面(TAP)阻滞是一种镇痛技术。添加右美托咪定可增强区域麻醉效果。本研究旨在评估右美托咪定是否能延长胃癌切除术后TAP阻滞的镇痛时间。

方法

计划行胃癌切除术的患者被随机分配接受生理盐水TAP阻滞(S组)、罗哌卡因TAP阻滞(R组)或罗哌卡因联合右美托咪定TAP阻滞(RD组)。记录视觉模拟评分(VAS)、术后恶心呕吐(PONV)评分、镇静评分、曲马多用量、罗哌卡因浓度及术后恢复质量问卷40(QoR-40)评分。

结果

与S组相比,R组和RD组患者术后2、4、12和24小时的VAS评分更低(P<0.05)。术后2、12、24和36小时,R组和RD组的PONV评分低于S组(P<0.05)。与S组相比,R组和RD组患者所需曲马多更少,QoR-40评分更高(P<0.05)。R组和RD组之间上述变量及罗哌卡因浓度无差异(P>0.05)。三组镇静评分相似(P>0.05)。

结论

TAP阻滞可提供镇痛并改善恢复质量。添加右美托咪定并不能显著改善TAP阻滞的质量或持续时间。

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Addition of dexmedetomidine to bupivacaine in transversus abdominis plane block potentiates post-operative pain relief among abdominal hysterectomy patients: A prospective randomized controlled trial.在腹横肌平面阻滞中,将右美托咪定添加到布比卡因中可增强子宫切除术患者术后的疼痛缓解效果:一项前瞻性随机对照试验。
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Perineural administration of dexmedetomidine in combination with ropivacaine prolongs axillary brachial plexus block.
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J Anesth. 2014 Aug;28(4):576-9. doi: 10.1007/s00540-013-1763-9. Epub 2013 Dec 18.
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Comparison of plasma concentrations of levobupivacaine with and without epinephrine for transversus abdominis plane block.比较含肾上腺素和不含肾上腺素的左旋布比卡因用于腹横肌平面阻滞的血浆浓度。
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Distribution patterns, dermatomal anesthesia, and ropivacaine serum concentrations after bilateral dual transversus abdominis plane block.双侧腹横肌平面阻滞的分布模式、皮区麻醉和罗哌卡因血清浓度。
Reg Anesth Pain Med. 2012 May-Jun;37(3):294-301. doi: 10.1097/AAP.0b013e31824c20a9.
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Should we stop doing blind transversus abdominis plane blocks?我们是否应该停止行盲横腹直肌平面阻滞?
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Pharmacokinetics of the local anesthetic ropivacaine after transversus abdominis plane block in healthy volunteers.健康志愿者腹横肌平面阻滞时局部麻醉药罗哌卡因的药代动力学。
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Perineural dexmedetomidine added to ropivacaine for sciatic nerve block in rats prolongs the duration of analgesia by blocking the hyperpolarization-activated cation current.罗哌卡因中加入神经周围用右美托咪定可通过阻断超极化激活阳离子电流延长大鼠坐骨神经阻滞的镇痛持续时间。
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