右美托咪定或地塞米松复合0.375%左旋布比卡因对超声引导下臂丛神经阻滞的影响  

Efficacy of adding Dexmedetomidine or Dexamethasone to 0.375% Levobupivacaine in ultrasound-guided brachial plexus block

作　　者：刘玉[1] 陈海涛[1] 刘绍正 王先锋[1] 

机构地区：[1]皖北煤电集团总医院麻醉科,安徽宿州234011

出　　处：《中国现代医学杂志》2016年第21期117-120,共4页China Journal of Modern Medicine

摘　　要：目的观察右美托咪定或地塞米松加入0.375%左旋布比卡因,用于超声引导下臂丛神经阻滞的效果和作用时间。方法选择行前臂和手部手术美国麻醉协会Ⅰ、Ⅱ级患者120例,随机分为生理盐水(NS)组、地塞米松(D)组、右美托咪定(DM)组,每组40例。所有患者在超声引导下行臂丛神经阻滞,使用药物均为0.375%左旋布比卡因。NS组在30 ml局部麻醉药物中加入2 ml生理盐水,D组在30 ml局部麻醉药物中加入2 ml(10 mg)地塞米松,DM组在30 ml局部麻醉药物中加入2 ml(100μg)右美托咪定。记录感觉阻滞起效时间、麻醉质量评分,以及感觉阻滞维持时间。结果与NS组比较,D组和DM组感觉阻滞起效时间缩短,感觉阻滞维持时间延长(P<0.05)。D组和DM组在感觉阻滞起效和感觉阻滞维持时间上比较,差异无统计学意义(P>0.05),3组的麻醉质量评分比较,差异无统计学意义(P>0.05)。结论 100μg右美托咪定和10 mg地塞米松复合左旋布比卡因在超声引导下臂丛神经阻滞中,能缩短感觉阻滞起效时间,延长感觉阻滞维持时间,但不能改善麻醉质量评分。Objective To assess the effectiveness of adding Dexmedetomidine or Dexamethasone to 0.375% Levobupivacaine in ultrasound-guided brachial plexus block. Methods This study was carried out in the General Hospital of Wanbei Coal-electric Group, A total of 120 patients classified into American Society of Anesthesiologists physical status Ⅰ-Ⅱ and receiving forearm and hand surgery under ultrasound-guided brachial plexus block were randomly allocated to receive 30 ml 0.375% Levobupivacaine with 2 ml of normal saline （group NS, n = 40）, 30 ml 0.375% Levobupivacaine with 2 ml （10 mg） of Dexamethasone （group D, n = 40） or 30 ml 0.375% Levobupivacaine with 2 ml （100 p.g） of Dexmedetomidine （group DM, n = 40）. The onset time and duration of sensory block and the score of anesthesia quality were assessed and recorded. Results The onset time of sensory block was shorter in the group D and the group DM than in the group NS （P 〈 0.01）. The sensory block duration was also prolonged in the group D and the group DM when compared with the group NS （P〈 0.05）, but there was no significant difference between the group D and the group DM （P〉 0.05）. However, there were no significant differences in the score of anesthesia quality among all the three groups （P〉 0.05）. Conclusions Dexmedetomidine 100 μg and Dexamethasone 10 mg are both effective in decreasing onset of block and extending the duration of Levobupivacaine in ultrasound-guided brachial plexus block but can＇t improve the score of anesthesia quality.

关 键 词：右美托咪定 地塞米松 左旋布比卡因 臂丛神经阻滞 超声 

分 类 号：R614[医药卫生—麻醉学]