■开胸术后疼痛控制非常重要,如果不受控制,它会导致严重的并发症。
■本研究旨在比较右美托咪定和氯胺酮在锯肌前平面阻滞(SAPB)开胸术后疼痛控制中的应用。
这项随机临床试验是对74名年龄在18至60岁的美国麻醉医师协会(ASA)I级或II级患者进行的,这些患者被转诊到阿瓦兹的伊玛目霍梅尼医院,伊朗,行开胸手术并随机分为两组。手术后,在超声引导下进行SAPB。在罗哌卡因-氯胺酮(RK)组中,氯胺酮0.5mg/kg和0.4cc/kg罗哌卡因溶液0.25%和罗哌卡因-右美托咪定(RD)组,除了0.4cc/kg罗哌卡因0.25%,添加右美托咪定0.5µg/kg.言语数字标度(VNS),收缩压(SBP),舒张压(DBP),呼吸频率(RR),心率(HR),记录平均动脉压(MAP)。
■两组在人口统计信息方面没有显着差异(P<0.05)。氯胺酮组的平均VNS低于右美托咪定组;然而,仅在术后1、12和24小时差异有统计学意义(P<0.05)。两组在SBP和DBP方面无统计学差异。HR,地图。术后12、24h两组RR差异有统计学意义(P<0.05)。
■右美托咪定和氯胺酮,在接受选择性开胸手术的患者中用作罗哌卡因SAPB的补充剂,降低了开胸手术后的疼痛强度;然而,在接受氯胺酮的组中,疼痛减轻的强度越来越有效。
UNASSIGNED: Postoperative pain control after thoracotomy is very important, and if not controlled, it can cause severe complications.
UNASSIGNED: This study aimed to compare dexmedetomidine and ketamine in serratus anterior plane block (SAPB) in pain control after thoracotomy.
UNASSIGNED: This randomized clinical trial was conducted on 74 patients aged 18 to 60 years old with American Society of Anesthesiologists (ASA) class I or II who were referred to Imam Khomeini hospital in Ahvaz, Iran, for thoracotomy and randomly divided into two groups. After surgery, the SAPB with ultrasound-guided was performed. In the ropivacaine-ketamine (RK) group, ketamine 0.5 mg/kg and 0.4 cc/kg ropivacaine solution 0.25% and in the ropivacaine-dexmedetomidine (RD) group, in addition to 0.4 cc/kg ropivacaine 0.25%, dexmedetomidine 0.5 µg/kg was added. Verbal Numeric Scale (VNS), systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (RR), heart rate (HR), and mean arterial blood pressure (MAP) were recorded.
UNASSIGNED: There was no significant difference in both groups in terms of demographic information (P < 0.05). The average VNS was lower in the ketamine group than in the dexmedetomidine group; however, there was a significant difference only at 1, 12, and 24 hours after surgery (P < 0.05). There was no statistically significant difference between the two groups in terms of SBP and DBP, HR, and MAP. There was a significant difference in the RR in the two groups at 12 and 24 hours after the operation (P < 0.05).
UNASSIGNED: Dexmedetomidine and ketamine, which were used as supplements to ropivacaine for SAPB in patients undergoing elective thoracotomy, reduced the pain intensity after thoracotomy; nevertheless, the intensity of pain reduction was more and more effective in the group receiving ketamine.