Departments of Anesthesiology and Critical Care, Arak University of Medical Sciences, Arak, Iran.
Students Research Committee, Arak University of Medical Sciences, Arak, Iran.
Med Gas Res. 2024 Sep 1;14(3):102-107. doi: 10.4103/2045-9912.385947. Epub 2023 Sep 17.
This study aimed to compare the effects of intrathecal dexmedetomidine, fentanyl and magnesium sulfate added to ropivacaine on the onset and duration of sensory and motor blocks in lower abdominal surgery. This double-blind randomized clinical trial included 90 patients scheduled for lower abdominal surgery at Vali-Asr Hospital in Arak, Iran. The enrolled patients were randomly divided into three equal groups and then underwent spinal anesthesia. The first group received 10 μg of dexmedetomidine, the second group received 50 μg of fentanyl, and the third group received 200 mg of 20% magnesium sulfate intrathecally in addition to 15 mg of 0.5% ropivacaine. In the dexmedetomidine group, the mean arterial blood pressure was lower than the other two groups (P = 0.001). Moreover, the time to onset of sensory block (P = 0.001) and the mean duration of sensory block (P = 0.001) were shorter and longer, respectively, in the dexmedetomidine group than in the other two groups. In the dexmedetomidine group, the mean time to onset of motor block (P = 0.001) and the mean duration of motor block (P = 0.001) were lower and higher than in the other two groups, respectively. There was no significant difference in visual analog scale score, heart rate, administered opioid, and drug side effects among the three groups. Dexmedetomidine caused early sensory and motor blocks while prolonging the duration of sensory and motor blocks compared with the other two groups. In addition, dexmedetomidine reduced mean arterial blood pressure in patients. Based on the findings of this study, it is recommended that dexmedetomidine can be used in order to enhance the quality of sensory and motor block in patients.
本研究旨在比较鞘内给予右美托咪定、芬太尼和硫酸镁对腹部下手术感觉和运动阻滞起效和持续时间的影响。这项双盲随机临床试验纳入了 90 名在伊朗阿拉克瓦利-阿斯尔医院行腹部下手术的患者。入组患者被随机分为三组，然后接受脊髓麻醉。第一组接受 10μg 右美托咪定，第二组接受 50μg 芬太尼，第三组鞘内给予 15mg0.5%罗哌卡因的同时给予 200mg20%硫酸镁。在右美托咪定组，平均动脉压低于其他两组（P=0.001）。此外，感觉阻滞的起效时间（P=0.001）和感觉阻滞的平均持续时间（P=0.001）更短和更长，分别在右美托咪定组比其他两组。在右美托咪定组，运动阻滞的起效时间（P=0.001）和运动阻滞的平均持续时间（P=0.001）的均值更低和更高，分别在其他两组。三组之间视觉模拟评分、心率、给予的阿片类药物和药物不良反应无显著差异。与其他两组相比，右美托咪定引起早期感觉和运动阻滞，同时延长感觉和运动阻滞的持续时间。此外，右美托咪定降低了患者的平均动脉压。基于本研究的结果，建议使用右美托咪定以提高患者感觉和运动阻滞的质量。
