右美托咪定联合罗哌卡因阻滞在经腹全子宫切除术后镇痛中的应用

目的:探讨右美托咪定联合罗哌卡因阻滞在经腹全子宫切除术后镇痛中的应用效果。方法:择期经腹全子宫切除术患者72例随机分为对照组与观察组各36例，对照组给予超声引导下罗哌卡因经腹横筋膜平面阻滞，观察组给予右美托咪定静脉镇痛联合超声引导下罗哌卡因经腹横筋膜平面阻滞。比较2组术后疼痛、镇静评分、并发症发生情况及患者总体镇痛满意度。结果:观察组术后4、12与24 h的疼痛评分均明显低于对照组（P<0.01）。观察组术后4、12与24 h的镇静评分与对照组差异均有统计学意义（P<0.01）。观察组术后24 h内头晕、恶心呕吐、嗜睡、呼吸抑制、尿潴留等并发症与对照组差异均无统计学意义（P>0.05）。观察组与对照组总体镇痛满意度评分差异有统计学意义（P<0.01）。结论:右美托咪定联合超声引导下罗哌卡因经腹横筋膜平面阻滞在经腹全子宫切除术后能更加有效发挥镇痛与镇静效果，减少并发症的发生，从而提高患者总体满意度。

The analgesia effect of dexmedetomidine combined with ropivacaine block after total hysterectomy

Objective:To explore the analgesia effects of dexmedetomidine combined with ropivacaine block after total abdominal hysterectomy. Methods:Seventy patients scheduled by total hysterectomy were radomly divided into the control group and observation group(36 cases each group). The control group were blocked by ropivacaine transabdominal fascia plane guided by ultrasound,the observation group were blocked by dexmedetomidine combined with ropivacaine transabdominal fascia plane guided by ultrasound. Results:The pain scores in observation group at postoperative 4 h,12 h and 24 h were significantly lower than those in control group (P<0. 01). The differences of the scores at postoperative 4 h,12 h and 24 h between two groups were statistically significant(P<0.01). The complications(including dizziness,nausea,vomiting,drowsiness,respiratory depression,urinary retention) in observation group at postoperative 24 h were significantly less than those in control group(P<0. 05). The overall analgesic satisfaction scores in observation group and control group were was statistically significant(P<0. 01). Conclusions:The dexmedetomidine combined with ropivacaine transabdominal fascia plane guided by ultrasound after total hysterectomy can effectively play the analgesia and sedation effects,reduce the complications and improve satisfaction of patients.