超声引导下局麻药复合右美托咪定腹横肌平面阻滞在妇科开腹手术患者中的应用效果

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Abstract Objective To explore application effects of ultrasound-guided transversus abdominis plane blocks (TAPB) with local anesthetics and Dexmedetomidine in patients with gynecological laparotomy. Methods Ninety patients underwent hysterectomy and ovarian cyst resection in Guangdong Hospital of Traditional Chinese Medicine from October 2014 to August 2016 were selected as research objects, and they were randomly divided into three groups by random number table: control group (group C), local anesthetic medicine group (T group), local anesthetics and Dexmedetomidine group (DT group), with 30 cases in each group. Patients in three groups were treated with normal endotracheal intubation and general anesthetic. After induction of anesthesia, B ultrasound-guided bilateral TAPB were performed in T group and DT group. The patients in T group and DT group were respectively injected with 30 mL of 0.4% Ropivacaine and 30 mL of 0.4% Ropivacaine combined with 0.75 μg/kg Dexmedetomidine. The recovery time of spontaneous breathing, waking time and extubation time of the three groups were compared, and postoperative visual analogue scale (VAS), Ramsay score and the incidence of adverse reactions were recorded, and the rates of temperature plane block in bilateral block sides were observed. The data was analyzed by statistical software SPSS 18.0. Results Compared with group C, the amount of Propofol in T group and DT group was reduced, the recovery time of spontaneous breathing, waking time and extubation time were shortened, and the VAS scores after operation for 8, 12, 24 h (T1-T3) were reduced (P ＜ 0.05). While compared with T group, the amount of Propofol in DT group was reduced, the recovery time of spontaneous breathing, waking time and extubation time were shortened, and the VAS scores at T1-T3 were reduced (P ＜ 0.05). There were no significant differences of Ramsay scores and the incidence of adverse reactions among the three groups (P ＞ 0.05). The rate of temperature plane block in block sides of T group and DT group after operation for 24 h was 76.7%, 86.7% respectively. Conclusion Local anesthetics combined with Dexmedetomidine for B ultrasound-guided TAPB has faster recovery of anesthesia and better postoperative analgesia, with high accuracy and safety in gynecological laparotomy.

Key words： Dexmedetomidine Ropivacaine Ultrasound Transversus abdominis plane blocks Gynecological laparotomy Postoperative analgesia

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	WU Jianwei PENG Juxiang HE Qiang XU Le LI Xiangyu ZHAO Weixian

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WU Jianwei PENG Juxiang HE Qiang XU Le LI Xiangyu ZHAO Weixian. Application effects of ultrasound-guided transversus abdominis plane blocks with local anesthetics and Dexmedetomidine in patients with gynecological laparotomy[J]. 中国医药导报, 2017, 14(34): 62-65.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2017/V14/I34/62

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