不同剂量右美托咪定辅助臂丛神经阻滞在骨科上肢手术中的作用  

Different doses of dexmedetomidine assisted brachial plexus blockade in upper extremity orthopedic surgery

作　　者：宋翠侠[1] 鲍育华[1] 芮昌松 

机构地区：[1]上海市第八人民医院麻醉科,上海200235

出　　处：《临床和实验医学杂志》2016年第9期917-919,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨不用剂量右美托咪定辅助臂丛神经阻滞在骨科上肢手术中的作用。方法选择择期行上肢手术的患者共120例,分为5组,其中A组至D组分别将右美托咪定0.5μg/kg(A组)、0.8μg/kg(B组)、1.0μg/kg(C组)、1.2μg/kg(D组)混合入0.4%罗哌卡因30 ml进行注射,每组24例。E组为对照组(24例),仅采用罗哌卡因。比较各组麻醉与阻滞效果。结果 A、B、C、D组患者感觉阻滞起效时间、运动阻滞起效时间较E组显著缩短,感觉阻滞持续时间、运动阻滞持续时间较E组显著延长,Ramsay镇静评分较E组均显著提高(P<0.05)。B、C、D组患者在感觉阻滞起效时间、运动阻滞起效时间,感觉阻滞持续时间和运动阻滞持续时间无显著差异(P>0.05)。C组Ramsay镇静评分显著高于B组,但显著低于D组(P<0.05)。结论 1.0μg/kg剂量右美托咪定复合罗哌卡因应用于骨科手术的辅助臂丛麻醉,获得了较好的镇痛、镇静效果,值得临床推广。Objective To investigate the different doses of dexmedetomidine assisted brachial plexus blockade in upper extremity orthopedic surgery. Methods A total of 120 cases undertaken elective upper extremity surgery were divided into five groups. Group A to D were given the dexmedetomidine from 0. 5 μg / kg（ group A）,0. 8 μg / kg（ group B）,1. 0 μg / kg（ group C）,1. 2 μg / kg（ group D）,which were mixed into0. 4% ropivacaine 30 ml for injection and 24 cases in each group. E group was the control group（ 24 cases）,using only ropivacaine. Retarding effects of anesthesia was compared between groups. Results Block onset time,motor block onset time was significantly shorter in A,B,C,D group than the E group,and sensory block duration,motor block duration was significantly longer than the E group. Ramsay sedation score were significantly increased compared with E group（ P〈0. 05）. Among B,C,D group,the onset time of sensory block,motor block onset time,sensory block duration and motor block duration had no significant difference（ P〉0. 05）. Ramsay sedation score in group C was significantly higher than in group B,but significantly lower than the D group（ P〈0. 05）. Conclusion 1. 0 μg / kg dexmedetomidine and ropivacaine applied to brachial plexus anesthesia can get a better analgesic,sedative effect in orthopedic surgery,which is worthy of promotion.

关 键 词：上肢手术 臂丛神经阻滞 右美托咪定 罗哌卡因 

分 类 号：R614[医药卫生—麻醉学]