摘要
目的探讨右美托咪定复合罗哌卡因在锁骨下臂丛神经外束、后束、内束的阻滞效果。方法选取2015年6月~2016年6月在我院行上肢肘关节以下骨科手术治疗的患者58例,采用随机数字表法将其分成右美托咪定复合罗哌卡因组(DR组)和纯罗哌卡因组(R)组,每组29例。两组均定位喙突内下2 cm处,在神经刺激器诱发外束、后束、内束后,DR组和R组分别注射三束神经右美托咪定0.5μg/kg复合罗哌卡因150 mg和罗哌卡因150 mg,容量为30 ml,每束支注射10 ml。记录给药后两组患者术侧感觉阻滞和运动阻滞情况和术中舒适度评级。记录两组患者不良反应发生率。结果两组患者的运动阻滞时间,差异无统计学意义(P>0.05),DR组患者的感觉起效时间、运动阻滞起效时间、感觉阻滞维持时间均优于R组,差异有统计学意义(P<0.01);DR组舒适度评级1级的比例(100.0%)高于R组(86.2%)(P<0.05)。两组患者均未出现心动过缓、低血压、呼吸抑制、恶心呕吐等不良反应,差异无统计学意义(P>0.05)。结论右美托咪定可缩短麻醉起效时间并延长感觉阻滞持续时间,提高手术过程的舒适度。
Objective To investigate the block effect of Dexmedetomidine combined with Ropivacaine in the external bundle,posterior bundle and internal bundle of subclavian brachial plexus.Methods From June 2015 to June 2016,58 patients who underwent orthopedic surgery under the elbow joint of upper extremity in our hospital were randomly divided into two groups,dexmedetomidine combined ropivacaine group(DR group)and pure ropivacaine group(R group),29 cases in each group.The two groups were positioned 2 cm below the coracoid process.After the nerve stimulator induced the external bundle,the posterior bundle and the internal bundle,the DR group and the R group were injected with 0.5μg/kg of Dexmedetomidine combined with 150 mg of Ropivacaine and 150 mg of Ropivacaine,with a capacity of 30 ml.Each bundle was injected with 10 ml.Postoperative sensory and motor block and intraoperative comfort rating were recorded in both groups.The incidence of adverse reactions was recorded in both groups.Results There was no significant difference in motor block time between the two groups(P>0.05).The onset time,onset time and duration of motor block in DR group were better than those in R group(P<0.01).The proportion of comfort grade 1(100.0%)in DR group was higher than that in R group(86.2%),the difference was statistically significant(P<0.05).There were no adverse reactions such as bradycardia,hypotension,respiratory depression,nausea and vomiting between the two groups(P>0.05).Conclusion Dexmedetomidine can shorten the onset time of anesthesia and prolong the duration of sensory block,and improve the comfort during the surgery.
作者
江琦
杨进辉
周丽华
辛典
吴宝华
JIANG Qi;YANG Jin-hui;ZHOU Li-hua;XIN Dian;WU Bao-hua(Department of Anesthesiology,Guangzhu Orthopedics Hospital,Guangzhou in Guangdong Province,Guangzhou 510045,China)
出处
《中国当代医药》
2018年第8期113-115,119,共4页
China Modern Medicine
基金
广东省广州市越秀区科技局项目(2015-WS-023)
关键词
右美托咪定
罗哌卡因
喙突
臂丛神经
锁骨下
Dexmedetomidine
Ropivacaine
Coracoid process
Brachial plexus
Subclavian
