右美托咪定复合罗哌卡因对小儿包皮手术中麻醉的效果及对小儿应激反应的影响

钱兴华,朱智瑞,胡智勇

中国临床解剖学杂志 ›› 2019, Vol. 37 ›› Issue (2) : 213-216.

中国临床解剖学杂志 ›› 2019, Vol. 37 ›› Issue (2) : 213-216. DOI: 10.13418/j.issn.1001-165x.2019.02.020
临床研究

右美托咪定复合罗哌卡因对小儿包皮手术中麻醉的效果及对小儿应激反应的影响

  • 钱兴华1,2, 朱智瑞1, 胡智勇1
作者信息 +

Effects of dexmedetomidine combined with ropivacaine on anesthesia and stress response in children

  • QIAN Xing-hua 1,2, ZHU Zhi-rui 1, HU Zhi-yong 1
Author information +
文章历史 +

摘要

目的 探讨右美托咪定复合罗哌卡因在小儿包皮手术中的麻醉效果及其对术后应激反应的影响。  方法 选取2016年8月~2017年8月本院收治的小儿包皮手术患者98例作为研究对象,随机分成两组,各49例,对照组采用罗哌卡因麻醉,研究组使用右美托咪定复合罗哌卡因实施麻醉。对比两组患儿麻醉镇痛效果、麻醉起效时间,患儿苏醒时间及术后躁动率、术后应激反应情况及不良反应。  结果 研究组麻醉镇痛效果明显优于对照组(P<0.05);研究组患儿的手术时间、麻醉起效时间与术后躁动率明显低于对照组(P<0.05);研究组的血糖、皮质醇与肾上腺素浓度等应激指标显著低于对照组(P<0.05);研究组不良反应产生率明显低于对照组(P<0.05)。  结论 右美托咪定复合罗哌卡因应用于小儿包皮手术麻醉中,可有效降低患儿的应激反应,在镇痛、镇静方面,提供了一种较为安全、便捷的镇痛方法,并发症少,值得临床推广应用。

Abstract

Objective To explore the effect of dexmedetomidine combined with ropivacaine on anesthesia in pediatric foreskin surgery and its effect on children's postoperative stress response. Methods A total of 98 cases of pediatric foreskin patients admitted to our hospital from August 2016 to August 2017 were selected as subjects of this study, and randomly divided into two groups with 49 cases each. The control group was treated with ropivacaine anesthesia, and the study group was treated with dexmedetomidine combined with ropivacaine for anesthesia. The analgesic effect, onset time, recovery time, postoperative restlessness rate, stress response and adverse reaction symptoms were compared between the two groups. Results The analgesic effect of the study group was significantly better than that of the control group (P<0.05). Operation time, onset time of anesthesia and postoperative restlessness rate of the study group were significantly lower than those of the control group (P<0.05). Stress indexes such as blood glucose, cortisol and adrenaline concentration in the study group were significantly lower than those in the control group (P<0.05). The adverse reaction rate of the study group was significantly lower than that of the control group (P<0.05). Conclusion The application of dexmedetomidine combined with ropivacaine in pediatric foreskin surgery can effectively reduce the stress response of children. In terms of analgesia and sedation, it provides a relatively safe and convenient analgesic method with few complications, which should be further promoted in clinical application.

关键词

  / 右美托咪定 /  罗哌卡因 /  小儿包皮手术 /  麻醉 /  效果 /  应激反应

Key words

Dexmedetomidine /  Ropivacaine /  Pediatric circumcision /  Anesthesia /  Effect /  Stress response

引用本文

导出引用
钱兴华,朱智瑞,胡智勇. 右美托咪定复合罗哌卡因对小儿包皮手术中麻醉的效果及对小儿应激反应的影响[J]. 中国临床解剖学杂志. 2019, 37(2): 213-216 https://doi.org/10.13418/j.issn.1001-165x.2019.02.020
QIAN Xing-hua, ZHU Zhi-rui, HU Zhi-yong. Effects of dexmedetomidine combined with ropivacaine on anesthesia and stress response in children[J]. Chinese Journal of Clinical Anatomy. 2019, 37(2): 213-216 https://doi.org/10.13418/j.issn.1001-165x.2019.02.020

参考文献

[1]  曾德亮, 章放香, 马熠, 等. 右美托咪定复合罗哌卡因连续腰丛神经阻滞对髋关节置换术后早期康复的影响[J]. 临床麻醉学杂志, 2016, 32(12): 1165-1168.
[2]  刘洁, 段光琦, 王啸, 等. 包皮环切吻合器与传统包皮环切术在小儿包皮手术中的疗效对比分析[J]. 齐齐哈尔医学院学报, 2015, 4(2): 186-187.
[3] Luan H, Zhu P, Zhang X, et al. Effect of dexmedetomidine as an adjuvant to ropivacaine for wound infiltration in patients undergoing open gastrectomy: A prospective randomized controlled trial[J]. Medicine, 2017, 96(38): e7950.
[4]  翟明玉, 李娟, 谷海, 等. 右美托咪定复合罗哌卡因腹横肌平面阻滞对亲属活体肾移植供肾患者术后恢复的影响[J]. 临床麻醉学杂志, 2016, 32(5): 441-444.
[5]  程琛, 张野, 李锐. 右美托咪定复合罗哌卡因在骶管麻醉中的应用[J]. 广东医学, 2017, 16(22): 3520-3523.
[6]  Zhai MZ, Wu HH, Yin JB, et al. Dexmedetomidine dose-dependently attenuates ropivacaine-induced seizures and negative emotions via inhibiting phosphorylation of amygdala extracellular signal-regulated kinase in mice[J]. Mol Neurobiol, 2016, 53(4): 2636-2646.
[7]  王美容, 李志鹏, 蒋群锰, 等. 右美托咪定配伍罗哌卡因单次坐骨神经阻滞对术后股神经旁置管镇痛效果的影响[J]. 实用医学杂志, 2017, 33(7): 1145-1148.
[8] PaletiS ,  Prasad PK ,  Lakshmi BS. A randomized clinical trial of intrathecal magnesium sulfate versus midazolam with epidural administration of 0.75% ropivacaine for patients with preeclampsia scheduled for elective cesarean section[J]. J Anaesthesiol Clin Pharmacol, 2018, 34(1): 23-28.
[9] 孙可, 金梅, 杨庆国. 罗哌卡因复合右美托咪定髂筋膜间隙阻滞对预防老年髋关节置换术苏醒期躁动的效果[J]. 实用医学杂志, 2016, 32(22): 3769-3771.
[10] 欧阳辉旺, 王正坤, 叶玉萍, 等. 小儿开腹手术中联合右美托咪定和罗哌卡因行腹横肌平面阻滞的效果[J]. 广东医学, 2017, 38(20): 3191-3193.
[11] Yu JM, Sun H, Wu C, et al. The analgesic effect of ropivacaine combined with dexmedetomidine for incision infiltration after laparoscopic cholecystectomy[J]. Surg Laparosc Endosc Percutan Tech, 2016, 26(6): 449-454.
[12] 张隆盛, 李春然, 陈孟, 等. 右美托咪定复合罗哌卡因腰骶丛神经阻滞在老年下肢骨折手术中的应用[J]. 广东医学, 2018, 18(8): 412-416.
[13] 张佣来, 沙蕊, 刘晶宇, 等. 罗哌卡因浸润麻醉联合地佐辛静脉麻醉对食管癌根治术患者全麻恢复期应激反应的影响[J]. 临床麻醉学杂志, 2016, 38(2): 139-143.
[14] 李红英, 张建杏, 王研, 等. 右美托咪定对大鼠神经元缺氧无糖损伤保护作用的实验研究[J]. 中国临床解剖学杂志, 2014, 32(4): 455-457.
[15]杨影. 罗哌卡因结膜下麻醉在斜视手术中的应用[J]. 实用医学杂志, 2016, 32(15): 2586-2587.

基金

浙江省医药卫生科研基金项目(2017KY443)


Accesses

Citation

Detail

段落导航
相关文章

/