摘要
目的:探讨右美托咪定(Dexmedetomidine,DEX)联合罗哌卡因(Ropivacaine,ROP)臂丛神经阻滞对断指再植(replantation of amputated finger)术患者的影响。方法:选取2020年1月-2021年1月南平市人民医院197例断指再植术患者。按照随机数字表法将其分为对照组(n=98)和试验组(n=99)。对照组给予ROP臂丛神经阻滞。在上述麻醉基础上,试验组加用DEX。比较两组入室前及术后24 h血流动力学指标、应激指标及碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF),镇静评分及疼痛,围手术期指标及不良反应。结果:两组入室前及术后24 h血氧饱和度(pulse oxygen saturation,SpO_(2))、心率(heart rate,HR)、平均动脉压(mean artery pressure,MAP)比较差异均无统计学意义(P>0.05)。试验组术后24 h超氧化物歧化酶(superoxide dismutase,SOD)、bFGF水平均高于对照组,丙二醛(malondialdehyde,MDA)水平低于对照组(P<0.05)。麻醉后10 min,试验组临床镇静评分系统(Ramsay sedation scores,RASS)评分显著高于对照组(P<0.05);术后24 h,试验组视觉模拟评分法(visual analogue scale,VAS)评分显著低于对照组(P<0.05)。试验组术中液体输入量、术中出血量均少于对照组(P<0.05)。试验组不良反应发生率显著低于对照组(P<0.05)。结论:DEX联合ROP臂丛神经阻滞能有效减轻断指再植术患者术后疼痛,降低不良反应发生率,镇静效果更好,改善应激指标。
Objective:To investigate the effect of Dexmedetomidine(DEX)combined with Ropivacaine(ROP)brachial plexus block on patients undergoing replantation of amputated finger operation.Method:A total of 197 patients undergoing replantation of amputated finger operation in Nanping People’s Hospital from January 2020 to January 2021 were selected.They were divided into control group(n=98)and test group(n=99)according to the method of random number table.The control group was given ROP brachial plexus block.On the basis of the above anesthesia,DEX was added to the test group.Hemodynamic indexes,stress indexes,basic fibroblast growth factor(bFGF)before entering the room and 24 hours after operation,sedation scores,pain,perioperative indexes and adverse reactions were compared between the two groups.Result:There were no significant differences in pulse oxygen saturation(SpO_(2)),heart rate(HR)and mean arterial pressure(MAP)between the two groups before entering the room and 24 hours after operation(P>0.05).The levels of superoxide dismutase(SOD)and bFGF in the test group were higher than those in the control group,while the level of malondialdehyde(MDA)24 h after operation in the test group was lower than that in the control group 24 hours after operation(P<0.05).Ten minutes after anesthesia,the Ramsay sedation scores(RASS)score in the test group was significantly higher than that in the control group(P<0.05);24 hours after operation,the visual analog scale(VAS)score in the test group was significantly lower than that in the control group(P<0.05).The amount of fluid input and intraoperative bleeding in the test group were less than those in the control group(P<0.05).The incidence of adverse reactions in the test group was significantly lower than that in the control group(P<0.05).Conclusion:DEX combined with ROP brachial plexus block can effectively reduce the postoperative pain of patients undergoing replantation of amputated finger operation,reduce the incidence of adverse reactions,have better sedative effect and improve stress indicators.
作者
黄建玲
蒋书明
HUANG Jianling;JIANG Shuming(Nanping People’s Hospital,Nanping 353000,China)
出处
《中外医学研究》
2022年第31期135-139,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
右美托咪定
罗哌卡因
臂丛神经阻滞
断指再植术
术后疼痛
Dexmedetomidine
Ropivacaine
Brachial plexus block
Replantation of amputated finger operation
Postoperative pain
