摘要目的 观察罗哌卡因复合右美托咪定用于腹横筋膜平面阻滞剖宫产术后镇痛中的效果。方法 选取2018年7月～2019年7月我院收治的90 例腰硬联合麻醉下行剖宫产术的产妇作为研究对象，按照入院顺序将其随机分为观察组和对照组，每组各45 例。两组产妇均行超声引导下腹横筋膜平面阻滞。对照组产妇予以罗哌卡因进行镇痛，观察组产妇在对照组基础上联合使用右美托咪定进行镇痛。两组产妇均行静脉自控镇痛（PCIA）。观察两组产妇的术后视觉模拟量表（VAS）评分、镇静评分标准（Ramsay）评分、术后24 h 内各时间点镇痛泵按压次数及不良反应总发生率。结果 观察组产妇术后8、12、24 h 的VAS 评分低于对照组，差异有统计学意义（P＜0.05）；观察组产妇术后4、8、12、24 h 的镇痛泵按压次数少于对照组，差异有统计学意义（P＜0.05）；两组产妇术后8、12、24 h 的Ramsay 评分比较，差异无统计学意义（P＞0.05）。两组产妇的不良反应总发生率比较，差异无统计学意义（P＞0.05）。结论 罗哌卡因复合右美托咪定用于腹横筋膜平面阻滞剖宫产术产妇，术后镇痛效果较好，可降低术后不良反应总发生率。
Abstract：Objective To observe the effect of Ropivacaine combined with Dexmedetomidine on analgesia after cesarean with abdominal transverse fascia plane block. Methods A total of 90 women who underwent cesarean with elective lumbar and spinal anesthesia from July 2018 to July 2019 were selected as the research objects and randomly divided into observation group and control group according to the order of admission, with 45 cases in each group. Ultrasoundguided transverse fascia plane block was performed in both groups. The women in the control group received Ropivacaine for analgesia. The women in the observation group combined with Dexmedetomidine for analgesia on the basis of the control group. The two groups both received patient controlled intravenous analgesia (PCIA). The postoperative visual analogue scale (VAS), the postoperative sedation score (Ramsay score)，the number of PCIA and the total incidence of adverse reactions within 24 hours after surgery were compared. Results The VAS scores at 8, 12 and 24 h after obstetrics in the observation group were lower than those of the control group, and the differences were statistically significant (P＜0.05). The number of times of analgesia pump pressure at 4, 8, 12 and 24 h after obstetrics were lower than those of the control group, and the differences were statistically significant (P＜0.05). The Ramsay scores of the two groups at 8, 12 and 24 h after obstetrics were compared, and the differences were not statistically significant (P＞0.05).There was no significant difference in the total incidence of adverse reactions between the two groups (P＞0.05). Conclusion Ropivacaine combined with Dexmedetomidine for patients with abdominal transverse fascia plane block cesarean has good postoperative analgesia effect and can reduce the overall incidence of postoperative adverse reactions.
郑文忠;李长红;颜学滔. 罗哌卡因复合右美托咪定在腹横筋膜平面阻滞剖宫产术后镇痛中的应用效果[J]. 中国当代医药, 2020, 27(25): 138-140.
ZHENG Wen-zhong; LI Chang-hong; YAN Xue-tao. Application effect of Ropivacaine combined with Dexmedetomidine on analgesia after cesarean with abdominal transverse fascia plane block. 中国当代医药, 2020, 27(25): 138-140.
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