不同剂量右美托咪定复合罗哌卡因行肌间沟臂丛神经阻滞的阻滞效果和不良反应  

Block effect and adverse reactions of different doses of dexmedetomidine combined with ropivacaine in patients with interscalene brachial plexus blocks

作　　者：陈晨[1] 高共鸣[2] 

机构地区：[1]江苏省常州市第一人民医院麻醉科,江苏常州213000 [2]江苏省常州市第二人民医院骨科,江苏常州213000

出　　处：《实用临床医药杂志》2016年第15期53-56,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨两种不同剂量的右美托咪定复合罗哌卡因行肌间沟臂丛神经阻滞的效果和不良反应。方法 40例行单侧上肢/手部手术的患者随机分为两组,即0.5μg/kg右美托咪定复合罗哌卡因组(DR1组)和1μg/kg右美托咪定复合罗哌卡因组(DR2组)。比较2组患者阻滞起效时间,阻滞后4、6、8、10、12和14 h的静息和运动阻滞效果,术后血流动力学改变和镇静等不良反应。结果 DR1组患者感觉和运动阻滞开始恢复和完全恢复的时间均显著早于DR2组患者(P<0.01);DR2组在6 h活动疼痛评分和术后8、10、12和14 h的静息和活动疼痛评分均显著优于DR1组(P<0.05)。结论 1μg/kg右美托咪定复合罗哌卡因较0.5μg/kg右美托咪定复合罗哌卡因用于肌间沟臂丛神经阻滞,可以增强臂丛神经阻滞效果且不增加不良反应。Objective To explore the block effect and adverse reactions of different doses of dexmedetomidine combined with ropivacaine in patients with interscalene brachial plexus blocks. Methods Forty patients with elective upper limb/hand surgery were randomly divided into 0.5 μg/kg dexmedetomidine combined with ropivacaine group （group DR1 ） and 1 μg/kg dexmedetomidine com- bined with ropivacaine group （ group DR2）. Block onset time, resting and motor block effects at 4, 6, 8, 10, 12 and 14 hours after blocking as well as hemodynamic changes and adverse reactions were compared between two groups. Results The time of sensory and motor block recovery in group DR1 were significantly shorter than those in group DR2 （P 〈 0.05 ）. The active pain score at 6 h and resting and active pain scores at 8, 10, 12, 14 h in group DR2 were significantly better than those in group DR1 （P 〈 0. 05 ）. Conclusion Combined with 0. 5 μg/kg dexmedetomidine and ropivacaine, 1μg/kgdexmedetomidine combined with ropivacaine for interscalene brachial plexus blocks can im- prove block effect without increasing the adverse reactions.

关 键 词：右美托咪定 罗哌卡因 肌间沟臂丛神经阻滞 

分 类 号：R614[医药卫生—麻醉学]