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0.75%等比重罗哌卡因联合右美托咪定与0.75%等比重罗哌卡因联合芬太尼用于下肢手术的比较研究

A Comparative Study between Intrathecal Isobaric Ropivacaine 0.75% Plus Dexmedetomidine and Isobaric Ropivacaine 0.75% Plus Fentanyl for Lower Limb Surgeries.

作者信息

Ravipati Prabhavathi, Isaac G Anand, Reddy P Narasimha, Krishna Leela, Supritha T

机构信息

Department of Anesthesiology, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India.

出版信息

Anesth Essays Res. 2017 Jul-Sep;11(3):621-626. doi: 10.4103/0259-1162.206857.

Abstract

BACKGROUND

Spinal anesthesia is used commonly intraoperatively. However, local anesthetics are associated with relatively short duration of action. A number of adjuvants have been used to prolong the postoperative analgesia.

OBJECTIVES

To compare efficacy of dexmedetomidine and fentanyl when given intrathecally as an adjuvant to 2.5 ml of 0.75% isobaric ropivacaine.

MATERIALS AND METHODS

Sixty selected patients were randomized to receive 2.5 ml of 0.75% isobaric ropivacaine with dexmedetomidine 5 mcg (Group RD) or 20 mcg of fentanyl (Group RF) intrathecally for lower limb surgeries, block characteristics, hemodynamic changes, and adverse effects were compared.

RESULTS

Efficacy of both the drugs when given intrathecally was studied. Mean time needed for sensory blockade at T10 was 156.4667 ± 33.78 s in Group RD and 185.2000 ± 35.17 s in Group RF. The results are clinically and statistically significant ( - 0.002). The mean of total duration of sensory block in Group RD was 194.400 min while it was 139.9000 min in Group RF which was clinically and statistically significant ( - 0.0001). Time taken for onset of motor block was almost same in both groups. The mean of total duration of motor block in Group RD was 136.7333 min while it was 94.8667 min in Group RF which was clinically and statistically significant ( - 0.000).

CONCLUSION

Dexmedetomidine at a dose of 5 μg added to 2.5 ml of ropivacaine provided earlier sensory blockade, prolonged duration of sensory and motor blockade for patients under intrathecal anesthesia for lower limb surgeries with no sedation.

摘要

背景

脊髓麻醉在手术中常用。然而,局部麻醉药的作用持续时间相对较短。已经使用了多种佐剂来延长术后镇痛时间。

目的

比较鞘内注射右美托咪定和芬太尼作为2.5毫升0.75%等比重罗哌卡因佐剂时的效果。

材料与方法

选取60例患者,随机分为两组,分别接受鞘内注射2.5毫升0.75%等比重罗哌卡因加5微克右美托咪定(RD组)或20微克芬太尼(RF组)用于下肢手术,比较两组的阻滞特征、血流动力学变化及不良反应。

结果

研究了两种药物鞘内注射时的效果。RD组T10感觉阻滞所需平均时间为156.4667±33.78秒,RF组为185.2000±35.17秒。结果在临床和统计学上具有显著性差异(P=-0.002)。RD组感觉阻滞总时长平均为194.400分钟,而RF组为139.9000分钟,在临床和统计学上具有显著性差异(P=-0.0001)。两组运动阻滞起效时间几乎相同。RD组运动阻滞总时长平均为136.7333分钟,而RF组为94.8667分钟,在临床和统计学上具有显著性差异(P=-0.000)。

结论

在2.5毫升罗哌卡因中加入5微克右美托咪定,可为下肢手术鞘内麻醉患者提供更早的感觉阻滞,延长感觉和运动阻滞时间,且无镇静作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96f8/5594778/972649165855/AER-11-621-g002.jpg

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