右美托咪定对臂丛神经阻滞下前臂创伤患者术中镇静效果及TNF-α、IL-1、IL-6水平的影响  

Effects of dexmedetomidine on intraoperative sedation and levels of TNF-α,IL-1 and IL-6 in forearm traumatic patients with brachial plexus block

作　　者：邱雯[1] 韩娟英[1] 吕培军[1] 韩英[1] 

机构地区：[1]宁波市第六医院麻醉科

出　　处：《中国生化药物杂志》2017年第2期238-240,共3页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的探讨右美托咪定对臂丛麻醉下行前臂创伤手术患者的镇静效果及炎症反应的影响,以期为行臂丛神经阻滞麻醉的患者镇静药物的选择提供参考。方法选取宁波市第六医院2015年7月～2016年6月于臂丛神经阻滞下行前臂创伤手术的80例患者,患者随机分为右美托咪定组（dexmedetomidine group,D组）和生理盐水组（control group,C组）,每组各40例。分别记录2组患者麻醉前（T0）、切皮时（T1）、手术开始后15 min（T2）、手术开始后30 min（T3）、出室前（T4）的平均动脉压（MAP）、心率（HR）、血氧饱和度（Sp O2）及上述各时点白介素-1（IL-1）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）浓度,同时测定各时点Ramsay镇静评分及术后对手术操作的遗忘程度。结果 2组患者麻醉前MAP、HR、SpO_2未见明显差异,D组患者切皮时（T1）、手术开始后15 min（T2）、手术开始后30 min（T3）、出室前（T4）的平均动脉压（MAP）、心率（HR）显著低于C组,差异有统计学意义（P〈0.05）。2组患者各时点SpO_2无统计学差异。T1～T4时点D组患者Ramsay镇静评分显著高于C组,差异有统计学意义（P〈0.05）。T1～T4时点D组患者IL-1β、IL-6、TNF-α显著低于C组,差异有统计学意义（P〈0.05）。结论右美托咪定对臂丛神经阻滞下前臂创伤患者具有良好的镇静效果,对血流动力学影响较小且有利于患者对术中操作的遗忘,对前臂创伤患者炎症反应亦有一定抑制作用。Objective To investigate the effects of dexmedetomidine on sedation and inflammatory response in patients undergoing brachial plexus anesthesia,to provide a reference for the selection of sedative drugs in forearm traumatic patients undergoing brachial plexus block anesthesia.Methods80 forearm traumatic patients underwent trauma surgery with brachial plexus nerve block from July 2015 to June 2016 were selected and randomly divided into two groups of dexmedetomidine group（dexmedetomidine group,D group） and normal saline group（control group,C group）,each group of 40 cases.The mean arterial pressure（MAP）,heart rate（HR） and blood oxygen saturation（Sp O2） were recorded before operation（T0）,incision（T1）,15 min（T2）,30 min（T3）.Interleukin-1（IL-1）,interleukin-6（IL-6） and tumor necrosis factor-α（TNF-α） were measured at different time points.At the same time,the Ramsay sedation score and the degree of amnesia after operation were measured.Results There were no significant differences in MAP,HR and SpO_2 before anesthesia between the two groups.In group D,MAP and HR were significantly lower than those in group C at T1,T2,T3 and T4,the difference was statistically significant（P〈0.05）.There was no statistical difference in SpO_2 between the two groups.The Ramsay sedation score of group D at T1 to T4 was significantly higher than that of group C,the difference was statistically significant（P〈0.05）.The levels of IL-1β,IL-6 and TNF-α in group D were significantly lower than those in group C at T1 to T4,the difference was statistically significant（P〈0.05）.Conclusion Dexmedetomidine has good curative effect on forearm traumatic patients with brachial plexus block and less hemodynamics changes,which is beneficial to patients＇ forgotten of operation and inhibition of inflammatory reaction in forearm traumatic patients.

关 键 词：右美托咪定 臂丛神经阻滞 炎症反应 镇静 

分 类 号：R614.4[医药卫生—麻醉学]