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0.5% 布比卡因鞘内注射联合吗啡和右美托咪定用于下肢骨科手术的比较研究:一项双盲随机临床试验

A Comparative Study of Intrathecal Hyperbaric Bupivacaine 0.5% with Morphine and Dexmedetomidine in Lower Limb Orthopedic Surgeries: A Double-Blind Randomized Clinical Trial.

作者信息

Ashfi Shadab, Haque Azizul, Kumar Mukesh, Lakra Ladhu

机构信息

Department of Anaesthesiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.

Department of Anaesthesiology-Cardiac Anaesthesia, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.

出版信息

Anesth Essays Res. 2022 Jul-Sep;16(3):373-377. doi: 10.4103/aer.aer_116_22. Epub 2022 Nov 15.

Abstract

BACKGROUND

Pain and its alleviation have been a challenge for humans for centuries. Sub arachnoid block is most commonly practiced method for anaesthesia for lower limb surgeries. Adjuvants like opioids and alpha 2 agonists have proven benefits in augmentation of effects of local anaesthetics for spinal anesthesia. The aim of this study was to compare the effects of morphine and dexmedetomidine for sub arachnoid block in lower limb orthopaedic surgeries.

MATERIAL AND METHODS

This is a prospective randomised controlled trial done in 120 patients who were posted for lower limb orthopaedic surgery. Along with bupivacaine, Group A received intrathecal dexmedetomidine while group B received intrathecal morphine.

RESULTS

the demographic profile was comparable in both the groups. The mean duration of motor block in Group A was 359.33 ± 34.4 and in Group B was 265.71 ± 28.47. The duration of rescue analgesia was almost double in Group A as compared to Group B with < 0.0001 (CL 95%).

CONCLUSION

Intrathecal dexmedetomidine and morphine both provided good postoperative analgesia. Dexmedetomidine provided a longer duration of analgesia than morphine, thereby increasing the time for first rescue analgesia, but at the cost of greater side effects.

摘要

背景

几个世纪以来,疼痛及其缓解一直是人类面临的挑战。蛛网膜下腔阻滞是下肢手术最常用的麻醉方法。阿片类药物和α2激动剂等佐剂已被证明在增强局部麻醉药用于脊髓麻醉的效果方面具有益处。本研究的目的是比较吗啡和右美托咪定在下肢骨科手术蛛网膜下腔阻滞中的效果。

材料与方法

这是一项前瞻性随机对照试验,对120例拟行下肢骨科手术的患者进行。除布比卡因外,A组接受鞘内注射右美托咪定,而B组接受鞘内注射吗啡。

结果

两组的人口统计学特征具有可比性。A组运动阻滞的平均持续时间为359.33±34.4,B组为265.71±28.47。A组补救镇痛的持续时间几乎是B组的两倍,差异有统计学意义(P<0.0001,95%可信区间)。

结论

鞘内注射右美托咪定和吗啡均能提供良好的术后镇痛效果。右美托咪定提供的镇痛持续时间比吗啡长,从而增加了首次补救镇痛的时间,但代价是副作用更大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93e5/9813983/4ad42759aade/AER-16-373-g001.jpg

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