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脊髓麻醉下剖宫产:不同剂量右美托咪定联合0.75%重比重罗哌卡因的比较:一项双盲随机试验

Cesarean Sections Under Spinal Anaesthesia: Comparison of Varying Doses of Dexmedetomidine Combined with 0.75% Hyperbaric Ropivacaine: A Double-Blind Randomized Trial.

作者信息

Nallam Srinivasa Rao, Kandala Srikavya, Kanipakam Sreelekha, Bathini Vinay, Chiruvella Sunil, Sesham Sonu

机构信息

Dr YSR Government Medical College, Department of Anaesthesia, Critical Care & Pain Medicine, Pulivendula, India.

Government Medical College, Department of Anaesthesia, Critical Care & Pain Medicine, Kadapa, India.

出版信息

Turk J Anaesthesiol Reanim. 2024 Sep 17;52(4):134-141. doi: 10.4274/TJAR.2024.241619.

Abstract

OBJECTIVE

The primary aim of this study was to evaluate the effects of 5 μg, 7.5 μg, and 10 μg doses of dexmedetomidine added to hyperbaric 0.75% ropivacaine on the duration of analgesia during cesarean section. Furthermore, the onset of sensory and motor block, hemodynamics, sedation, and adverse effects were investigated.

METHODS

A total of 120 full-term parturients scheduled for cesarean section under spinal anaesthesia were randomized into three groups. Group RD5 received intrathecal hyperbaric 0.75% ropivacaine 15 mg (2 mL) plus dexmedetomidine 5 μg (0.5 mL), group RD7.5 received intrathecal hyperbaric 0.75% ropivacaine 15 mg (2 mL) plus dexmedetomidine 7.5 μg (0.5 mL), and group RD10 received intrathecal hyperbaric 0.75% ropivacaine 15 mg (2 mL) plus dexmedetomidine 10 μg (0.5 mL). Sensorimotor blockade characteristics, analgesia duration, hemodynamic variables, and adverse events were documented. Student's t-test and the chi-square test were used for data analysis.

RESULTS

In groups RD5, RD7.5, and RD10, the onset of sensory block was 2.96±1.32 min, 2.26±1.50 min, and 1.96±0.93 min, respectively, while the onset of motor block was 9.63±0.11 min, 8.63±0.58 min, and 6.40±0.14 min, respectively. The duration of analgesia was significantly prolonged in group RD10 compared with groups RD7.5 and RD5 (483.43±76.21 vs. 398.74±73.59 vs. 362.58±79.87 min, respectively, =0.001). Group RD10 also exhibited significantly higher incidences of sedation, bradycardia, and vomiting.

CONCLUSION

We conclude that increasing dexmedetomidine doses decreases the onset of sensory and motor blockade while prolonging analgesia duration in a dose-dependent manner.

摘要

目的

本研究的主要目的是评估在剖宫产手术中,向0.75%的高压罗哌卡因中添加5μg、7.5μg和10μg剂量右美托咪定对镇痛持续时间的影响。此外,还研究了感觉和运动阻滞的起效时间、血流动力学、镇静情况及不良反应。

方法

总共120例计划在脊髓麻醉下进行剖宫产的足月产妇被随机分为三组。RD5组接受鞘内注射15mg(2mL)0.75%高压罗哌卡因加5μg(0.5mL)右美托咪定,RD7.5组接受鞘内注射15mg(2mL)0.75%高压罗哌卡因加7.5μg(0.5mL)右美托咪定,RD10组接受鞘内注射15mg(2mL)0.75%高压罗哌卡因加10μg(0.5mL)右美托咪定。记录感觉运动阻滞特征、镇痛持续时间、血流动力学变量和不良事件。采用学生t检验和卡方检验进行数据分析。

结果

在RD5组、RD7.5组和RD10组中,感觉阻滞的起效时间分别为2.96±1.32分钟、2.26±1.50分钟和1.96±0.93分钟,而运动阻滞的起效时间分别为9.63±0.11分钟、8.63±0.58分钟和6.40±0.14分钟。与RD7.5组和RD5组相比,RD10组的镇痛持续时间显著延长(分别为483.43±76.21分钟、398.74±73.59分钟和362.58±79.87分钟,=0.001)。RD10组的镇静、心动过缓和呕吐发生率也显著更高。

结论

我们得出结论,增加右美托咪定剂量可缩短感觉和运动阻滞的起效时间,同时以剂量依赖的方式延长镇痛持续时间。

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