右美托咪定联合罗哌卡因腹横平面阻滞对小儿腹腔镜隐睾固定术术后镇痛效果的影响

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Abstract Objective To investigate effect of Dexmedetomidine combined with Ropivacaine transversus abdominal plane block (TAPB) on analgesia after laparoscopic cryptorchidism in children. Methods Sixty children undergoing elective laparoscopic cryptorchidism in Anesthesia Department of Guangzhou Women and Children Medical Center from March to October 2018 were divided into control group (group C, Ropivacaine group) and Dexmedetomidine group (group D, Dexmedetomidine combined with Ropivacaine group) by using random number table method, 30 cases in each group. After tracheal intubation, bilateral TAPB was guided by ultrasound. All patients were treated with intravenous controlled analgesia pump (PCIA) after operation. The heart rate (HR) and mean arterial pressure (MAP) at admission (T1), 10 minutes after TAPB (T2), time of skin incision (T3) and end of operation (T4) were recorded. Ramsay and PAED scores were performed after operation. FLACC scores of children at 2, 6, 12, 24 and 48 hours after operation were recorded, and the times of PCIA pump pressing 48 hours after operation and total amount of Sufentanil used 24 hours after operation were recorded. Results There was no significant difference in HR and MAP levels at T1 and T4 between two groups (P > 0.05); there was significant difference in HR and MAP levels at T2 and T3 between two groups (P < 0.05). There was no significant difference in HR and MAP levels at different time in group C (P > 0.05), but there was significant difference in HR and MAP levels at different time in group D (P < 0.05). There was no significant difference in Ramsay score between two groups (P > 0.05). PAED score and incidence of restlessness in group D were significantly lower than those in group C (P < 0.05). There was no significant difference in FLACC score between two groups at 2 and 48 hours after operation (P > 0.05); FLACC score of group D at 6, 12 and 24 hours after operation was lower than that of group C (P < 0.05). There were significant differences in FLACC scores between 2 h hours and 6,12, 24 hours in group C (P < 0.05), and had no significant differences in FLACC scores at different time in group D (P > 0.05). The effective pressing times and actual pressing times of PCIA pump in group D 48 hours after operation were less than those in group C, with statistical significance (P < 0.05); total amount of Sufentanil used in group D 24 hours after operation was less than that in group C, with statistical significance (P < 0.05). Conclusion Dexmedetomidine combined with Ropivacaine TAPB can prolong the postoperative analgesic time and improve the analgesic effect of patients undergoing laparoscopic cryptorchidism, reduce the use of opioids after operation, and reduce the incidence of restlessness during recovery period.

Key words： Dexmedetomidine α2 adrenal receptor Transversus abdominal plane block Pediatric laparoscopy Postoperative analgesia

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	FAN Yanting1 WU Guiyun2 BAI Xue1 WEI Wei1 XU Yingyi1▲

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FAN Yanting1 WU Guiyun2 BAI Xue1 WEI Wei1 XU Yingyi1▲. Effect of Dexmedetomidine combined with Ropivacaine transversus abdominal plane block on analgesia after laparoscopic cryptorchidism in children[J]. 中国医药导报, 2019, 16(22): 103-106,114.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I22/103

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