罗哌卡因联合右美托咪定用于骶管麻醉对痔切除术患者的镇痛作用的影响：前瞻性随机对照试验
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Effect of dexmedetomidine added to ropivicaine for caudal anesthesia in patients undergoing hemorrhoidectomy: A prospective randomized controlled trial
背景与目的
探讨右美托咪定联合罗哌卡因对痔切除术患者感觉阻滞开始时间、阻滞持续时间及麻醉结束后镇痛效果的影响。
方 法
50例成人痔切除术患者分为2组。罗哌卡因组（R组）：18 mL 0.3%罗哌卡因+ 2 mL生理盐水进行骶管麻醉。罗哌卡因联合右美托咪定组（RD组）：18 mL 0.3% 罗哌卡因+2毫升1μg /kg右美托咪定。观察心率、平均血压、感觉阻滞开始时间、持续时间、镇痛持续时间。
结 果
与R组比较，RD组感觉阻滞的起效时间缩短（9.2±1.3 vs 7.2±1.2），感觉阻滞的持续时间（3.0±0.7 vs 3.8±0.8）和镇痛持续时间（3.9±0.7 vs 5.3±0.8）延长（P <.05）。 除基线外，各组观察时间点RD组心率和平均动脉压均低于R组（P <.05）。试验中无心动过缓或低血压事件发生。
结 论
右美托咪定作为罗哌卡因的辅助用药，延长了骶管阻滞的持续时间，改善了术后镇痛，且其对接受痔切除术的成年患者没有明显的副作用。
原始文献摘要
Deming X , Mingyu X , Xiaobao Z , et al. Effect of dexmedetomidine added to ropivicaine for caudal anesthesia in patients undergoing hemorrhoidectomy[J]. Medicine, 2018, 97(34):e11731-
BACKGROUNDTo assess the effect of dexmedetomidine added to ropivaccaine on the onset and duration of sensory block, as well as postoperative analgesia during caudal anesthesia in patients undergoing hemorrhoidectomy.
METHODS Fifty adult patients scheduled for hemorrhoidectomy were divided into 2 groups. The group R received caudal anesthesia using 18 mL 0.3% ropivacaine plus 2 mL normal saline. The group RD received 18 mL 0.3% ropivacaine plus 2 mL 1 μg/kg dexmedetomidine. Heart rate, mean blood pressure, onset time and duration of sensory block, and duration of analgesia were observed.
RESULTS The onset time of sensory block was shortened (9.2 ± 1.3 vs 7.2 ± 1.2), and the duration of sensory block (3.0 ± 0.7 vs 3.8 ± 0.8) and duration of analgesia (3.9 ± 0.7 vs 5.3 ± 0.8) were prolonged in group RD compared with group R (P < .05). The heart rate and the mean blood pressure were also lower in the group RD compared with group R at each observation time points, except the baseline (P < .05). No bradycardia or hypotension was reported.
CONCLUSION Dexmedetomidine as an adjuvant to ropivacaine prolonged the duration of caudal block and improved postoperative analgesia without significant side effects in adult patients undergoing hemorrhoidectomy.
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贵州医科大学高鸿教授课题组
编辑：王贵龙 审校：李华宇