右美托咪定复合罗哌卡因在小儿骶管阻滞中的临床应用

目的观察右美托咪定复合罗哌卡因在小儿骶管阻滞中的临床应用。方法择期骶管阻滞下行单侧腹股沟疝手术患儿70例,随机分为两组:RD组和R组。RD组注入0.25%罗哌卡因+1μg/kg右美托咪定,R组注入0.25%罗哌卡因,注射总容积均为1 ml/kg。观察记录两组患者麻醉起效时间、苏醒时间和镇痛维持时间;苏醒期躁动评分采用Anon四分评分法,记录术后躁动发生率;采用OPS法评定术后2 h、4 h、8 h、12 h、24 h镇痛效果。结果 RD组阻滞起效时间较R组明显缩短(P0.05),镇痛维持时间和苏醒时间较R组明显延长(P0.05),术后8 h、12 h RD组OPS评分明显低于R组(P0.05),苏醒后躁动的发生率较R组明显降低(P0.05)。结论 1μg/kg右美托咪定可以增强罗哌卡因小儿骶管阻滞的镇痛效果,降低术后躁动的发生率。

Study on clinical application of dexmedetomidine combined with ropivacaine for caudal block in pediatric patients

Objective To study the effect of application of dexmedetomidine combined with ropivacaine in caudal block of pediatric pa-tients. Methods Seventy pediatric patients with indirect inguinal hernia were randomly divided into group RD and group R. All these patients had received caudal block before surgery. Patients in group RD were given with 1μg/kg dexmedetomidine combined with 0. 25% ropivacaine,pa-tients in group R were applied with 0. 25% ropivacaine 1ml/kg. The time for onset of caudal block,the recovery of consciousness and the adminis-tration of analgesics were recorded. Anon＇s Four Point Scale had been used to evaluate the incidence of post-operation agitation. OPS scores were scaled at 2 h,4 h,8 h,12 h and 24 h after surgery to assess the analgesic effect. Results In group RD,the effect of caudal block took action faster significantly（ P 〈0. 05）. The recovery time and duration of analgesia were significantly prolonged（ P 〈0. 05）. The incidence of post-operation agitation and OPS scores at 8 h and 12 h were significantly lowered（ P 〈0. 05）. Conclusion The application of 1μg/kg Dexmedeto-midine can enhance the effect of caudal block with ropivacaine in pediatric patients,and decrease the incidence of post-operational agitation.