不同剂量右美托咪定对罗哌卡因臂丛神经阻滞效果的影响  

Influence of different doses of dexmedetomidine on block effect of ropivacaine brachial plexus block

作　　者：杨川[1] 贾绍茂 何丽云[1] 陈贤华[1] 谭首鹏[1] 刘涛涛[2] 

机构地区：[1]四川省广元市第二人民医院麻醉科,四川广元628017 [2]四川省广元市朝天区人民医院麻醉科,四川广元628000

出　　处：《实用医院临床杂志》2015年第4期118-120,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨不同剂量右美托咪定对罗哌卡因臂丛神经阻滞效果的影响。方法 100例择期行上肢手术患者按随机数字表法分为罗哌卡因组（R组）及不同剂量右美托咪定混合罗哌卡因组（RD1～RD4组）共5组各20例。采用超声引导下肌间沟臂丛神经阻滞,R组单次注射0.4%罗哌卡因30 ml;RD1～RD4组分别单次注射含右美托咪定0.5μg/kg（RD1组）、0.8μg/kg（RD2组）、1.0μg/kg（RD3组）、1.2μg/kg（RD4组）的0.4%罗哌卡因30 ml。记录各组感觉和运动神经阻滞起效时间、持续时间、术中Ramsay镇静评分及心血管事件、呼吸抑制、气胸等不良反应发生情况。结果 RD1～RD4组较R组、RD2～RD4组较RD1组感觉和运动神经阻滞起效时间缩短,持续时间延长,差异均有统计学意义（P〈0.05）。Ramsay镇静评分比较,RD1～RD4组高于R组,RD3、RD4组高于RD1和RD2组,差异均有统计学意义（P〈0.05）。RD3组与RD4组分别有1例和2例出现心动过缓和低血压,其余各组未见不良反应发生。结论右美托咪定0.8μg/kg混合0.4%罗哌卡因30 ml可安全、有效地用于臂丛神经阻滞。Objective To investigate the influence of different doses of dexmedetomidine on block effect of ropivacaine brachial plexus block.Methods One hundred patients undergoing upper limb operation were divided into ropivacaine group（group R） and ropivacaine mixed with different doses of dexmedetomidine groups（group RD1～ RD4） according to the random number table.Each group had 20 cases.An inter-scalene brachial plexus block was performed guided by ultrasound.In the group R,0.4% ropivacaine 30 ml was injected while 0.4% ropivacaine 30 ml mixed with different doses of dexmedetomidine were injected（0.5 μg/kg in the group RD1,0.8 μg/kg in the group RD2,1.0 μg/kg in the group RD3 and 1.2 μg/kg in the group RD4,respectively）.The onset time of sensory and motor nerve block,the time of duration,Ramsay sedation score during operation and the adverse reactions（cardiovascular events,respiratory depression and pneumothorax） were compared among the groups.Results The onset time of sensory and motor nerve block in the groups RD1～ RD4 was shortened and the time of duration time was extended when compared to the group R.Moreover,the onset time in the groups RD2～ RD4 was shortened and the duration time was extended when compared to the group RD1.The differences were statistically significant（P〈0.05）.Ramsay sedation score in the groups RD1～ RD4 was higher than that in the group R,and the score in the groups RD3 and RD4was higher than that in the RD1 and RD2.The differences were also statistically significant（P〈0.05）.There was one case in the group RD3 and two cases in the group RD4 with bradycardia and hypotension during the operation.Conclusion It is safe and effective when use dexmedetomidine 0.8 μg/kg mixed with 0.4% ropivacaine 30 ml in brachial plexus block.

关 键 词：右美托咪定 酰胺类 臂丛神经阻滞 麻醉效果 

分 类 号：R614.32[医药卫生—麻醉学]