右美托咪定、芬太尼和局部麻醉用于视网膜手术的球周阻滞比较

W. Abu-Elwafa, Islam S. H. Ahmed, Salah-Eldin Abdul-Aziz, A. Hassan
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引用次数: 0

摘要

在所有的区域阻滞中,球周阻滞是大多数眼科手术中最受欢迎的一种,因为它的并发症很少。目的探讨局麻药与右美托咪定或芬太尼混合用于玻璃体视网膜手术球周阻滞的效果。患者和方法本研究包括40例在Sohag大学医院接受选择性视网膜手术的成人患者(ASA II-IV)。所有患者均接受以下联合治疗:利多卡因2%、布比卡因0.5%、透明质酸酶15 IU/Ml,同时给予芬太尼20 μg (F组)或右美托咪定20 μg (D组)。记录术后镇痛持续时间、发作时间、感觉和运动阻滞持续时间以及其他并发症。结果F组运动和感觉阻滞的持续时间明显长于D组,感觉和运动阻滞的持续时间明显长于F组(P=0.05)。D组要求镇痛所需时间明显长于F组(P=0.0002)。F组扑热息痛总用量明显高于D组(P=0.001)。F组需要纳布啡的患者总数明显高于d组(P=0.003)。在术后2、4、6 h, F组的视觉模拟量表明显高于d组。结论右美托咪定-局麻混合物用于视网膜手术的球周阻滞在运动、感觉阻滞的发生和持续时间、术后镇痛、镇痛需求等方面优于芬太尼-局麻混合物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Peribulbar block for retinal surgery comparison among dexmedetomidine, fentanyl, and local anesthesia
Introduction Among all the regional blocks, the peribulbar block is one of the most popular for most ophthalmic procedures as it has few complications. Aim To study the effects of mixing local anesthetic with either dexmedetomidine or fentanyl in the peribulbar block for vitreoretinal surgery. Patients and methods The study included 40 adult patients (ASA II–IV) who had a peribulbar block for elective retinal surgery at Sohag University Hospital. All patients received the following combination: lidocaine 2%, bupivacaine 0.5%, hyaluronidase 15 IU/Ml, in addition to either 20 μg of fentanyl (group F) or 20 μg of dexmedetomidine (group D). The duration of postoperative analgesia, the onset, and duration of sensory and motor blocks, along with other complications, were recorded. Results The onset time of motor and sensory blocks was significantly longer in group F. For the duration of sensory and motor blocks, group D had a significantly greater duration than group F (P=0.05). Group D took substantially longer to request analgesia than group F (P=0.0002). Total paracetamol consumption was substantially higher in group F than in group D (P=0.001). The overall number of patients who required nalbuphine was substantially higher in group F (P=0.003) than in group D. At 2, 4, and 6 h postoperatively, the visual analog scale was statistically significantly greater in group F than in group D. Conclusion Dexmedetomidine-local anesthetic mixture in the peribulbar block for retinal surgery was superior to fentanyl-local anesthetic mixture regarding onset and duration of motor, sensory block, postoperative analgesia, and analgesic requirement.
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