肌间沟神经阻滞联合右美托咪定的术后镇痛作用：对照研究
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Postoperative analgesia with dexmedetomidine in interscalene block： Comparative study
背景与目的
右美托咪定可延长罗哌卡因的感觉阻滞作用时间。我们的目的为：与可乐宁相比，评价右美托咪定在肩关节镜手术病人术后镇痛中的作用。
方 法
本研究为随机、对照、对比试验，将研究对象随机分为三组：I组（对照组）：0.75%罗哌卡因；II组：0.75%罗哌卡因+可乐宁（1mg∕kg）；III组：0.75%罗哌卡因+右美托咪定（1mg∕kg），超声引导下单次剂量行肌间沟神经阻滞。术后6、12、24h记录病人感觉及运动阻滞情况、疼痛等级、镇静评分、心率、呼吸频率、血压。
结 果
术后6h，I组和II组病人疼痛级别为中度到重度，III组病人疼痛级别为轻度；术后12h，I组和II组重度疼痛病人超过60%，III组仅为10%;术后24h，I组和II组中度疼痛病人为20%.
结 论
术后24h内，肌间沟神经阻滞联合右美托咪定具备较好的术后镇痛作用。
原始文献摘要
Velázquez-Delgado , Gaspar-Carrillo , Peña-Riveron , et al.；Postoperative analgesia with dexmedetomidine in interscalene block. Comparative study；[J]. Revista Española De Anestesiología Y Reanimación, 2017, 64(3):137-143.
Abstract：
Introduction: Dexmedetomidine prolongs sensory block of ropivacaine. Our objective was to study whether this extension would produce better postoperative pain control compared to that produced by clonidine in patients undergoing arthroscopic shoulder.
Materials and methods: A comparative, longitudinal, controlled, randomised study into 3 groups. Control group I: ropivacaine 0.75% clonidine, group II: 0.75% ropivacaine plus cloni-dine 1 mg/kg, group III dexmedetomidine: 0.75% ropivacaine plus dexmedetomidine 1 mg/kg. Interscalene block single dose ultrasound-guided. Sensory and motor blockade, pain intensity, sedation level, heart rate, respiratory rate, blood pressure at 6, 12 and 24 h were measured.
Results: Pain intensity at 6 h in groups I and II showed moderate to severe pain, and mild pain in group III. At 12 h the groups I and II showed moderate to severe pain by more than 60% of patients, and in group III only 10%. At 24 h groups I and II showed 20% of patients continued with moderate Conclusion: The prolonged interscalene block produced by dexmedetomidine provided better postoperative pain control during the first 24 h.
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