{"title":"硬膜外右美托咪定、氯定加布比卡因用于脐下手术的疗效比较分析","authors":"Anjana Hazarika, Yuwaraj Majumdar","doi":"10.21276/ijcmr.2020.7.6.18","DOIUrl":null,"url":null,"abstract":"Introduction: Pain was defined by Mountcastle in the year 1968 as “that sensory experience evoked by stimuli that injures”. It is a subjective feeling and failure to relieve pain in any procedure cannot be accepted, both ethically and morally, and adequate pain relief must be treated as basic human right. Pain relief both in peri-operative and post-operative period is the crux of anaesthesia. The aim of the study was to evaluate the efficacy of epidural Dexmedetomidine and Clonidine as an adjuvant to Bupivacaine in patients undergoing infraumbilical surgeries. Material and Methods: Seventy (70) patients aged 20-60 years (ASA I-II) undergoing infraumbilical surgery were randomly allocated to two groupsGroup BD receiving epidurally 15ml Bupivacaine (0.5%) + Dexmedetomidine (1mg/kg) and Group BC receiving 15ml Bupivacaine (0.5%) + Clonidine (1mg/kg). After securing I/V line, infusion started with R/L and under strict aseptic condition, patients were administered epidural block via 18G Tuohy needle in the sitting or lateral position at L3-L4 intervertebral space. Results: We observed that the time taken for the onset of sensory block at T10 level, time for sensory block upto T6 and the time taken for maximum motor block is less in Group BD compared to Group BC. Regarding the post-operative block, the time to sensory two segment regression, time to sensory regression to S1, time for recovery of motor block and time to first rescue analgesia were more in Group BD compared to Group BC. And the difference between the two groups were significant (p<0.001). Conclusion: On the basis of the findings of our present clinical study, we can come to conclusion that Dexmedetomidine is more effective epidural adjuvant compared to Clonidine in patients undergoing infraumbilical surgery.","PeriodicalId":13918,"journal":{"name":"International Journal of Contemporary Medical Research [IJCMR]","volume":"22 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative Analysis of the Efficacy of Epidural Dexmedetomidine and Clonidine with Bupivacaine in Patients Undergoing Infraumbilical Surgeries\",\"authors\":\"Anjana Hazarika, Yuwaraj Majumdar\",\"doi\":\"10.21276/ijcmr.2020.7.6.18\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction: Pain was defined by Mountcastle in the year 1968 as “that sensory experience evoked by stimuli that injures”. It is a subjective feeling and failure to relieve pain in any procedure cannot be accepted, both ethically and morally, and adequate pain relief must be treated as basic human right. Pain relief both in peri-operative and post-operative period is the crux of anaesthesia. The aim of the study was to evaluate the efficacy of epidural Dexmedetomidine and Clonidine as an adjuvant to Bupivacaine in patients undergoing infraumbilical surgeries. Material and Methods: Seventy (70) patients aged 20-60 years (ASA I-II) undergoing infraumbilical surgery were randomly allocated to two groupsGroup BD receiving epidurally 15ml Bupivacaine (0.5%) + Dexmedetomidine (1mg/kg) and Group BC receiving 15ml Bupivacaine (0.5%) + Clonidine (1mg/kg). After securing I/V line, infusion started with R/L and under strict aseptic condition, patients were administered epidural block via 18G Tuohy needle in the sitting or lateral position at L3-L4 intervertebral space. Results: We observed that the time taken for the onset of sensory block at T10 level, time for sensory block upto T6 and the time taken for maximum motor block is less in Group BD compared to Group BC. Regarding the post-operative block, the time to sensory two segment regression, time to sensory regression to S1, time for recovery of motor block and time to first rescue analgesia were more in Group BD compared to Group BC. And the difference between the two groups were significant (p<0.001). Conclusion: On the basis of the findings of our present clinical study, we can come to conclusion that Dexmedetomidine is more effective epidural adjuvant compared to Clonidine in patients undergoing infraumbilical surgery.\",\"PeriodicalId\":13918,\"journal\":{\"name\":\"International Journal of Contemporary Medical Research [IJCMR]\",\"volume\":\"22 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Contemporary Medical Research [IJCMR]\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.21276/ijcmr.2020.7.6.18\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Contemporary Medical Research [IJCMR]","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21276/ijcmr.2020.7.6.18","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
引言:1968年,蒙特卡斯尔将疼痛定义为“由伤害刺激引起的感官体验”。疼痛是一种主观感受,不能在任何程序中减轻疼痛,这在伦理和道德上都是不可接受的,充分的疼痛减轻必须被视为基本的人权。围术期和术后疼痛的缓解是麻醉的关键。该研究的目的是评估硬膜外右美托咪定和克拉定作为布比卡因辅助治疗脐下手术患者的疗效。材料与方法:将70例20 ~ 60岁(ASA i ~ ii)行脐下手术的患者随机分为两组:BD组硬膜外布比卡因(0.5%)+右美托咪定(1mg/kg) 15ml; BC组布比卡因(0.5%)+克拉定(1mg/kg) 15ml。固定I/V线后,开始灌注R/L,在严格无菌条件下,在L3-L4椎间隙用18G Tuohy针坐位或侧卧位进行硬膜外阻滞。结果:我们观察到,与BC组相比,BD组T10级感觉阻滞发生时间、T6级感觉阻滞时间和最大运动阻滞时间均短于BC组。术后阻滞方面,BD组感觉两段回归时间、感觉S1段回归时间、运动阻滞恢复时间、首次抢救镇痛时间均高于BC组。两组比较差异有统计学意义(p<0.001)。结论:根据我们目前的临床研究结果,我们可以得出结论,右美托咪定在脐下手术患者的硬膜外辅助治疗中比克拉定更有效。
Comparative Analysis of the Efficacy of Epidural Dexmedetomidine and Clonidine with Bupivacaine in Patients Undergoing Infraumbilical Surgeries
Introduction: Pain was defined by Mountcastle in the year 1968 as “that sensory experience evoked by stimuli that injures”. It is a subjective feeling and failure to relieve pain in any procedure cannot be accepted, both ethically and morally, and adequate pain relief must be treated as basic human right. Pain relief both in peri-operative and post-operative period is the crux of anaesthesia. The aim of the study was to evaluate the efficacy of epidural Dexmedetomidine and Clonidine as an adjuvant to Bupivacaine in patients undergoing infraumbilical surgeries. Material and Methods: Seventy (70) patients aged 20-60 years (ASA I-II) undergoing infraumbilical surgery were randomly allocated to two groupsGroup BD receiving epidurally 15ml Bupivacaine (0.5%) + Dexmedetomidine (1mg/kg) and Group BC receiving 15ml Bupivacaine (0.5%) + Clonidine (1mg/kg). After securing I/V line, infusion started with R/L and under strict aseptic condition, patients were administered epidural block via 18G Tuohy needle in the sitting or lateral position at L3-L4 intervertebral space. Results: We observed that the time taken for the onset of sensory block at T10 level, time for sensory block upto T6 and the time taken for maximum motor block is less in Group BD compared to Group BC. Regarding the post-operative block, the time to sensory two segment regression, time to sensory regression to S1, time for recovery of motor block and time to first rescue analgesia were more in Group BD compared to Group BC. And the difference between the two groups were significant (p<0.001). Conclusion: On the basis of the findings of our present clinical study, we can come to conclusion that Dexmedetomidine is more effective epidural adjuvant compared to Clonidine in patients undergoing infraumbilical surgery.