右美托咪定辅助臂丛神经阻滞的临床效果  

Clinical efficiency of auxiliary use of dexmedetomidine during brachial plexus block

作　　者：潘军里[1] 李钧[1] 徐凯[1] PAN Junli;LI Jun;XU Kai(Department of Anesthsiology ,Hangzhou Plastic Surgery Hospital,Hangzhou 310011, CHINA)

机构地区：[1]杭州整形医院麻醉科,浙江310011

出　　处：《江苏医药》2019年第1期48-50,共3页Jiangsu Medical Journal

摘　　要：目的观察右美托咪定辅助臂丛神经阻滞的临床效果。方法臂丛神经阻滞下行手外伤择期手术患者80例分为两组,每组40例。臂丛麻醉效果确切后,D组10min内泵注右美托咪定0.5μg/kg,继以0.4μg·kg^(-1)·h^(-1)静脉泵注至手术结束;P组先静脉缓慢推注丙泊酚2mg/kg,继以2～4mg·kg^(-1)·h^(-1)静脉泵注维持至手术结束。记录静脉给药前(T1)、切皮时(T2)、手术开始后30min(T3)和手术结束时(T4)的MAP、HR和RR;术中采用警觉/镇静评分(OAA/S评分)评估患者镇静程度;术后1h行VAS疼痛评分,记录不良反应发生情况。结果在T3、T4时,D组HR低于P组,MAP和RR高于P组(P<0.05)。D组在T2、T3、T4时OAA/S评分高于P组(P<0.05);术后1h,D组VAS疼痛评分低于P组(P<0.05)。两组不良反应发生情况相仿(P>0.05)。结论与静脉输注丙泊酚比较,右美托咪定辅助臂丛神经阻滞用于手外伤手术时,对患者的呼吸循环影响小,能提高患者的舒适度。Objective To observe the clinical efficiency of auxiliary use of dexmedetomidine during brachial plexus block.Methods Brachial plexus block was performed in 80 patients with hand injury undergoing surgery,who were randomly assigned into two groups with 40 cases each.A loading dose of dexmedetomidine 0.5μg/kg was infused in 10 minutes soon after brachial plexus block was complete in group D,which was followed by an infusion of dexmedetomidine 0.4μg·kg-1·h-1 until the end of operation.Propofol 2 mg/kg was slowly injected intravenously in group P,which was followed by an infusion of propofol 2-4 mg·kg^-1·h^-1 until the end of operation.MAP,HR and RR were recorded before administration of dexmedetomidine or propofol(T1),immediately after skin incision(T2),at 30 minutes after skin incision(T3)and at the end of operation(T4).OAA/S sedation score was evaluated.VAS pain score was evaluated one hour after operation.The incidence of adverse responses was recorded.Results At T3 and T4,HR was lower and MAP and RR were higher in group D than those in group P(P<0.05).OAA/S scores at T2,T3 and T4 were higher in group D than those in group P(P<0.05).VAS pain score one hour after operation was lower in group D than that in group P(P<0.05).The incidences of adverse responses of both groups were similar(P>0.05).Conclusion Compared to propofol infusion,dexmedetomidine-assisted brachial plexus block has less effect on the respiratory and circulatory function and produces better comfort of the patients undergoing surgery for hand injury.

关 键 词：右美托咪定 丙泊酚 臂丛阻滞 手外伤 

分 类 号：R614[医药卫生—麻醉学]