Luan Hengfei, Zhu Pin, Zhang Xiaobao, Tian Liang, Feng Jiying, Wu Yong, Yan Yongxin, Zhao Zhibin, Gu Xiaoping
Department of Anesthesiology Department of Gastrointestinal Surgery, Lianyungang Clinical College of Nanjing Medical University, The First People's Hospital of Lianyungang City, Lianyungang Department of Anesthesiology, Affiliated Drum Tower Hospital of Nanjing Medical University, Nanjing, China.
Medicine (Baltimore). 2017 Sep;96(38):e7950. doi: 10.1097/MD.0000000000007950.
The primary objective of this study was to investigate whether dexmedetomidine could potentiate the analgesic efficacy of ropivacaine, when added to ropivacaine for wound infiltration in patients undergoing open gastrectomy.
Fifty patients scheduled for open gastrectomy were divided into 2 equal groups that were received wound infiltration using 20 mL 0.3% ropivacaine plus 2 mL normal saline (group R) or 20 mL 0.3% ropivacaine plus 2 mL 1.0 μg/kg dexmedetomidine (group DR). Visual analogue scale (VAS) pain score, patient-controlled analgesia (PCA) pump press number, sufentanil consumption, postoperative nausea and vomiting (PONV), and wound healing score were recorded.
The VAS pain score were comparable between the 2 groups at the observation time points (P > .05), PCA pump press number and sufentanil consumption were higher in group R than that in group DR at 0 to 2, 2 to 4, 4 to 6 time intervals (P < .05) except for 6 to 8, 8 to 10, 10 to 12 time intervals (P > .05), meanwhile, the 24 hours total sufentanil consumption was also higher in group R than that in group DR (90.4 ± 20.5 vs 79.2 ± 9.4) (P < .05), there were no significant differences in PONV and wound healing score between the 2 groups (P > .05).
Dexmedetomidine as an adjuvant to ropivacaine for wound infiltration promoted the analgesic efficacy of ropivacaine, reduced sufentanil consumption, and had no effect on wound healing; it could be as an ideal adjuvant which could potentiate the analgesic efficacy of local anesthetics.
本研究的主要目的是探讨在接受开放胃切除术的患者中,右美托咪定添加到罗哌卡因中用于伤口浸润时,是否能增强罗哌卡因的镇痛效果。
将50例计划行开放胃切除术的患者分为两组,每组25例,分别接受20毫升0.3%罗哌卡因加2毫升生理盐水(R组)或20毫升0.3%罗哌卡因加2毫升1.0微克/千克右美托咪定(DR组)进行伤口浸润。记录视觉模拟评分(VAS)疼痛评分、患者自控镇痛(PCA)泵按压次数、舒芬太尼用量、术后恶心呕吐(PONV)及伤口愈合评分。
在各观察时间点,两组的VAS疼痛评分相当(P>0.05);在0至2、2至4、4至6时间间隔内,R组的PCA泵按压次数和舒芬太尼用量高于DR组(P<0.05),但在6至8、8至10、10至12时间间隔内两组相当(P>0.05);同时,R组24小时舒芬太尼总用量也高于DR组(90.4±20.5 vs 79.2±9.4)(P<0.05);两组的PONV及伤口愈合评分无显著差异(P>0.05)。
右美托咪定作为罗哌卡因伤口浸润的辅助用药,可增强罗哌卡因的镇痛效果,减少舒芬太尼用量,且对伤口愈合无影响;它可作为增强局部麻醉药镇痛效果的理想辅助药物。