右美托咪定对超声引导下小儿腹横肌平面阻滞罗哌卡因浓度的影响被引量：17

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摘要目的应用序贯法测定右美托咪定对超声引导下小儿腹横肌平面(transversus abdominis plane,TAP)阻滞罗哌卡因浓度的影响。方法选择拟行择期腹股沟斜疝修补或鞘膜积液切除手术(单侧)的患儿60例,ASAⅠ~Ⅱ级,年龄1~5岁。随机分为罗哌卡因组(R组,0. 2%罗哌卡因,1 m L/kg)和右美托咪定+罗哌卡因组(DR组,0. 2%罗哌卡因+2μg/kg右美托咪定,1 m L/kg),每组30例,面罩吸入七氟醚诱导,喉罩置入后超声引导下行TAP阻滞,以医学序贯实验方法(up-down)确定下一例患儿罗哌卡因浓度,初始浓度为0. 2%,上下浓度比值为1. 2,若切皮时小儿心率(HR)及平均动脉压(MAP)的变化超过切皮前的20%,则定义为"不满意",下例患儿提高一个浓度,相反则降低一个浓度。取得的数据以logistic回归分析方法计算出两组罗哌卡因的半数效应浓度(EC_(50))、95%效应浓度(EC_(95))及其95%CI。结果 R组罗哌卡因EC_(50)为0. 151%(95%CI 0. 125%~0. 191%),EC_(95)为0. 213%(95%CI 0. 180%~0. 512%); DR组罗哌卡因EC50为0. 117%(95%CI 0. 106%~0. 130%),EC95为0. 141%(95%CI 0. 129%~0. 196%),DR组低于R组,差异有统计学意义(P <0. 05)。结论混合使用2μg/kg的右美托咪定能明显降低小儿腹股沟斜疝修补或鞘膜积液切除手术超声引导下TAP阻滞罗哌卡因最低有效浓度并能够提供良好的术后镇痛。

作者沈阳张海燕李春林张忠其

机构地区南方医科大学顺德医院附属杏坛医院麻醉科南方医科大学顺德医院(佛山市顺德区第一人民医院)麻醉科

出处《广东医学》 CAS 2018年第18期2820-2822,2826,共4页 Guangdong Medical Journal

基金佛山市医学科研立项课题(编号:20170294)

关键词右美托咪定腹横肌平面阻滞罗哌卡因小儿最低有效浓度

分类号 R726.1 [医药卫生—儿科]

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参考文献3

1欧阳辉旺,王正坤,叶玉萍,刘国栋.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. 被引量：11
2张忠其,邢祖民,张艳静,刘永峰.术中单次注射右美托咪定在小儿包皮环切术中的应用[J].广东医学,2016,37(11):1701-1703. 被引量：8
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