右美托咪定辅助臂丛神经阻滞的镇静效果  

Efficacy of dexmedetomidine in sedation of patients undergoing brachial plexus block

作　　者：康焕菊[1] 曹苏[1] 

机构地区：[1]南通大学附属医院麻醉科,江苏省226001

出　　处：《江苏医药》2015年第14期1674-1676,共3页Jiangsu Medical Journal

摘　　要：目的比较右美托咪定、咪达唑仑和丙泊酚辅助臂丛神经阻滞的镇静效果。方法臂丛麻醉下行上肢手术患者60例随机均分为三组:D组辅以右美托咪定1μg/kg泵注10min,继以0.5μg·kg-1·h-1维持;M组给予咪达唑仑0.05mg/kg泵注5min,继以0.05mg·kg-1·h-1维持;P组给予丙泊酚2mg/kg泵注10min,继以5mg·kg-1·h-1维持。三组均通过调整药物用量至患者警觉/镇静(OAA/S)评分达3分,并维持手术全程。比较三组的起效时间、苏醒时间、生命体征及不良反应。结果 D组起效时间和苏醒时间均长于M组和P组(P<0.05)。与给药前相比,镇静期间三组均出现不同程度的HR减慢和BP下降(P<0.05)。D组无呼吸抑制病例,M组和P组分别有3例和5例出现呼吸抑制。结论臂丛神经阻滞辅以右美托咪定镇静,安全有效,优于咪达唑仑和丙泊酚。Objective To compare the sedative efficacy of dexmedetomidine,midazolam and propofol in the patients undergoing brachial plexus block.Methods Sixty patients scheduled for upper limb surgery under brachial plexus block were equally and randomly divided into 3groups.Group D received a loading dose of dexmedetomidine 1μg/kg for 10 minutes,which was followed by an infusion of dexmedetomidine 0.5μg·kg-1·h-1.Group M received loading dose of midazolam 0.05mg/kg for5 minutes,which was followed by an infusion of midazolam 0.05mg·kg^-1·h^1.Group P received a loading dose of propofol 2 mg/kg for 10 minutes,which was followed by an infusion of propofol5mg·kg^-1·h^-1.The infusion rate was adjusted to keep OAA/S sedation score at 3points in all cases.The onset and offset time,the change of life signs and adverse effects were compared among three groups.Results The onset and offset times were longer in group D than those in the other two groups（P〈0.05）.HR and MAP of three groups were lower during sedation than those before（P〈0.05）.SpO2 during sedation was fairly in normal range in group D,but hypoxia occurred in3 cases of group M and 5cases of group P.Conclusion Dexmedetomidine is safe and effective for the sedation of patients under brachial plexus block,which is better than midazolam and propofol.

关 键 词：右美托咪定 咪达唑仑 丙泊酚 臂丛神经阻滞 镇静 

分 类 号：R614[医药卫生—麻醉学]