Comparison of Local Wound Infiltration with Ropivacaine Alone or Ropivacaine Plus Dexmedetomidine for Postoperative Pain Relief after Lower Segment Cesarean Section.
Comparison of Local Wound Infiltration with Ropivacaine Alone or Ropivacaine Plus Dexmedetomidine for Postoperative Pain Relief after Lower Segment Cesarean Section.
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DOI：
10.4103/aer.aer_14_17
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发表时间：
2017-10
期刊：
影响因子：
--
通讯作者：
Katyal S
中科院分区：
文献类型：
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作者：
Bhardwaj S;Devgan S;Sood D;Katyal S
右美托咪定是一种α2-肾上腺素能激动剂，与局麻药联合给药时，可改善起效速度、镇痛持续时间并减少局麻药剂量。本研究的目的是比较罗哌卡因单独与罗哌卡因+右美托咪定局部皮下伤口浸润用于下段剖宫产术（LSCS）术后疼痛缓解的疗效。本研究是一项前瞻性、随机对照、双盲研究。将60例属于美国麻醉医师协会I级或II级身体状况的女性患者随机分为两组，每组30例患者。A组：0.75%罗哌卡因（3 mg/kg）用生理盐水稀释至40 ml局部皮下浸润创面。B组：局部皮下伤口浸润0.75%罗哌卡因（3 mg/kg）加右美托咪定（1.5 μg/kg）的体重，用生理盐水稀释至40 ml。使用标准脊髓麻醉技术并进行LSCS。在闭合皮肤前，通过局部皮下伤口浸润给予分配的药物。在术后24 h内使用视觉模拟评分法（VAS）评估疼痛，记录首次给予补救镇痛药的时间、平均镇痛药用量、患者满意度和术后24 h内不良反应的发生率。将所有观察结果制成表格，并使用卡方检验和非配对t检验进行统计学分析。B组中需要补救镇痛剂的患者总数、每次给予补救镇痛剂时的平均VAS以及术后24 h内需要的平均镇痛剂均少于A组。右美托咪定加罗哌卡因用于手术伤口浸润显著降低了LSCS患者的术后疼痛和急救镇痛药消耗。未发现严重不良反应。
Dexmedetomidine, α2-adrenergic agonist, when coadministered with local anesthetics, improves the speed of onset, duration of analgesia and decreases the dose of local anesthetic used. The aim of this study was to compare the efficacy of local subcutaneous wound infiltration of ropivacaine alone with ropivacaine plus dexmedetomidine for postoperative pain relief following lower segment cesarean section (LSCS). The study was a prospective, randomized control, double-blind study. Sixty female patients belonging to physical status American Society of Anesthesiologists Grade I or II scheduled for LSCS under spinal anesthesia were randomly allocated into two groups of thirty patients each. Group A: local subcutaneous wound infiltration of 0.75% ropivacaine (3 mg/kg) diluted with normal saline to 40 ml. Group B: local subcutaneous wound infiltration of 0.75% ropivacaine (3 mg/kg) plus dexmedetomidine (1.5 μg/kg) of the body weight diluted with normal saline to 40 ml. Standard spinal anesthesia technique was used and LSCS was conducted. The allocated drug was administered by local subcutaneous wound infiltration before closure of the skin. In postoperative period, pain was assessed using visual analog scale (VAS) over a period of 24 h, time of giving first rescue analgesic consumption, mean analgesic consumption, patient satisfaction, and incidence of side effects in 24 h postoperative period was noted. All observations were tabulated and statistically analyzed using Chi-square test and unpaired t-test. A total number of patients requiring rescue analgesic, mean VAS each time rescue analgesic was given, and the mean analgesic required in 24 h postoperative period was lesser in Group B than in Group A. Dexmedetomidine added to ropivacaine for the surgical wound infiltration significantly reduces postoperative pain and rescue analgesic consumption in patients undergoing LSCS. No serious adverse effects were noted.