右美托咪定与布托啡诺作为罗哌卡因佐剂对臂丛神经阻滞的影响  

The effects of dexmedetomidine and butorphanol as the adjuvant to ropivacaine for brachial plexus block

作　　者：郑琳琳 王伟芝[2] 类维富[3] ZHENG Linlin;WANG Weizhi;LEI Weifu(Department of Anesthesiology,Weifang Medical University,Weifang 261053,China;Department of Anesthesiology,Weifang People’s Hospital;Department of Anesthesiology,Qilu Hospital of Shandong University)

机构地区：[1]潍坊医学院麻醉学系,山东潍坊261053 [2]潍坊市人民医院麻醉科 [3]山东大学齐鲁医院麻醉科

出　　处：《潍坊医学院学报》2020年第1期16-18,共3页Acta Academiae Medicinae Weifang

摘　　要：目的比较右美托咪定和布托啡诺作为罗哌卡因佐剂对肌间沟法臂丛神经阻滞效果的影响。方法选择ASAⅠ~Ⅱ级择期行上肢手术患者60例,随机分为C组(1ml生理盐水+0.5%罗哌卡因20ml)、D组(0.75μg/kg的右美托咪定稀释到1ml+0.5%罗哌卡因20ml)和B组(1mg的布托啡诺稀释到1ml+0.5%罗哌卡因20ml),每组20例。比较感觉和运动阻滞的起效时间、持续时间,记录术后4,8,12,24h的疼痛评分(VAS)以及术中不良反应情况。结果D组感觉、运动阻滞起效时间比C,B组短,差异有显著性(P<0.05);D,B两组感觉、运动阻滞的持续时间比C组长,差异有显著性(P<0.05)。术后4h VAS评分比较,3组患者差异无显著性(P>0.05),术后8,12,24h的VAS评分比较,D,B组均低于C组,差异有显著性(P<0.05)。3组患者术中不良反应发生率比较,差异无显著性(P>0.05)。结论右美托咪定及布托啡诺作为局部麻醉药的佐剂均能延长臂丛神经阻滞的作用时间,减轻术后疼痛,且不增加术中不良反应的发生率。Objective To compare the effects of dexmedetomidine(Dex)and butorphanol as the adjuvant to ropivacaine for intermuscular groove brachial plexus block.Methods Sixty patients,ASAⅠorⅡ,scheduled for upper limb surgery under ultrasound-guided intermuscular groove brachial plexus block were enrolled and randomly divided into three groups as group C(1ml NS+0.5%ropivacaine 20ml),group D(0.75μg/kg Dex+1ml NS+0.5%ropivacaine 20ml),group B(1mg butorphanol+1ml NS+0.5%ropivacaine 20ml).The adjuvant was added to local anesthetic drug composed by 10ml 1%ropivacaine and 10ml NS.Onset time of sensory and motor block,duration of analgesia,visual analog scale at 4,8,12,and 24h after surgery were recorded in three groups.Results The onset of sensory and motor block in group D are earlier than group C and B(P<0.05).Duration of sensory block and motor block in group D and B were significantly longer than group C(P<0.05).Visual analog scale at 8,12and 24h in group D and B were lower than group C(P<0.05).Conclusion Both dexmedetomidine and butorphanol as adjuvants for local anesthetics can prolong the action time of brachial plexus block and alleviate postoperative pain without increasing the incidence of adverse reac-tions during the operation.Dexmedetomidine and butorphanol as anesthetic adjuvants can prolong the duration of brachial plexus block,and postoperative pain in patients,without increasing the incidence of adverse reactions during operation.

关 键 词：右美托咪定 布托啡诺 罗哌卡因 臂丛神经阻滞 

分 类 号：R614[医药卫生—麻醉学]