右美托咪定复合臂丛神经阻滞对骨折患者血清bFGF的影响  

Effect of dexmedetomidine combined with ropivacaine in brachial plexus block on serum b FGF of fracture patients

作　　者：顾义兴 高静[2] 陈林[2] 刘畅[2] 

机构地区：[1]武警8740部队医院麻醉科,四川南充637000 [2]第三军医大学西南医院麻醉科,重庆400038

出　　处：《局解手术学杂志》2015年第6期660-662,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的研究右美托咪定（Dex）复合臂丛神经阻滞对骨折患者围术期血清碱性成纤维细胞生长因子（bFGF）水平的影响。方法择期上肢手术患者80例（ASAⅠ-Ⅱ级），随机分成右美托咪定复合罗哌卡因组（RD组）和单纯罗哌卡因组（R组），每组40例。在喙突内下2em左右处，由神经刺激器引导下给予药物，R、RD组分别给予罗哌卡因200mg及罗哌卡因200mg复合右美托咪定1μg／kg，容量均为40mL。分别于11D～T4各时间点抽血5mL，测定骨折患者血清中bFGF的浓度。结果与R组比较，RD组在T1-T3时MAP、HR显著降低（P〈0．05）；在，ID—T4各时间点时SPO：差异无统计学意义（P〉0．05）。与∞比较，RD组及R组在T1～T4时间点，血清bFGF浓度均呈上升趋势（P〈0．05）；与R组比较，RD组T1-T4的bFGF浓度升高（P〈0．05）。结论Dex复合臂丛神经阻滞促进bFGF分泌的力度比单纯臂丛神经阻滞更大，促进患者的术后骨折愈合，但对心动过缓的患者要谨慎使用。Objective To investigate the effect of dexmedetomidine （Dex） combined with ropivacaine in brachial plexus block （BPB） on serum basic fibroblast growth factor （bFGF） levels of upper limb fracture patients in the perioperative period. Methods 80 patients （ ASA grade Ⅰ-Ⅱ ） scheduled for selective upper extremity surgery were randomly divided into the dexmedetomidine combined with ropiva- caine group （RD group） and the ropivacaine group （R group） with 40 patients in each group. BPB was performed at the point of 2 cm below coracoid directed by nerve stimulator. Ropivacaine （200 mg） was diluted into 40 mL in group R and ropivacaine （200 mg） ＋ 1 μg/kg dexmedetomidine were diluted into 40 mL in group RD. Drew 5 mL blood at T0-T4 points respectively, and serum bFGF concentration were determined. Results Compared with group R, MAP and HR at T1 - 33 points were significantly lower in group RD （P 〈 0. 05）. SpO2 in the two groups at each point had no statistical significance （P 〉 0. 05 ）. Compared with TO points, bFGF concentration were increased in two groups at T1 - T4 points （P 〈 0.05）, and it was higher in group RD compared with group R （P 〈 0. 05）. Conclusion Dex combined bra- chial plexus block promote the secretion of bFGF more than simple brachial plexus block,which is conducive to fracture healing after opera- tion, but it should be cautious to apply for patients with bradyarrhythmia.

关 键 词：臂丛神经阻滞 骨折 右美托咪定 碱性成纤维细胞生长因子 

分 类 号：R614.4[医药卫生—麻醉学]