右美托咪定联合布比卡因蛛网膜下腔阻滞麻醉应用于单侧下肢手术的效果研究  

Effect of dexmedetomidine combined with bupivacaine subarachnoid block anesthesia on unilateral lower limb surgery

作　　者：杜大春 童江荣 李晓晖 付星火 杨赞[1] 

机构地区：[1]江苏省泰州市第四人民医院麻醉科,江苏泰州225300

出　　处：《临床医药文献电子杂志》2017年第37期7143-7144,7146,共3页Electronic Journal of Clinical Medical Literature

摘　　要：目的观察右美托咪定联合布比卡因蛛网膜下腔阻滞用于单侧下肢手术患者手术的效果。方法拟行单侧下肢手术患者60例,ASAⅠ或Ⅱ级,性别不限,年龄20~62岁,体重指数(BMI)18~24kg/m2。随机分为三组,每组20例:组Ⅰ:0.5%布比卡因2.0 ml+0.5 ml生理盐水;组Ⅱ:0.5%布比卡因2.0ml+2.5μg右美托咪定;组Ⅲ:0.5%布比卡因2.0 ml+5μg右美托咪定。采用针刺法评估感觉阻滞效果,记录起效和维持时间;用改良的Bromage评分法评估非术侧下肢的运动阻滞效果,记录起效和维持时间;于术后1~24 h评定患者VAS评分。结果三组感觉阻滞起效时间无明显差异(P>0.05),Ⅱ组和Ⅲ组感觉阻滞维持时间明显延长(P<0.05或P<0.001),且呈剂量依赖性;与Ⅰ组相比,Ⅱ组和Ⅲ组运动阻滞起效时间明显缩短(P<0.05或P<0.001),Ⅲ组运动阻滞维持时间显著延长(P<0.01);与Ⅰ组相比,Ⅲ组VAS评分在术后4 h及8 h显著降低(P<0.05或P<0.01),并呈剂量依赖性。结论 5μg右美托咪定联合布比卡因鞘内注射优点显著,适合单侧下肢手术患者的麻醉。Objective To observe the effect of dexmedetomidine combined with bupivacaine subarachnoid block for unilateral lower limb surgery. Methods 60 patients with unilateral lower limb surgery, ASA grade Ⅰ or Ⅱ,with unlimited sex,aged 20-62 years,and body mass index （BMI） 18-24 kg/m2.Were randomly divided into three groups,20 cases in each group：group 1：0.5% bupivacaine 2 ml＋0.5 ml saline;group Ⅱ：0.5% bupivacaine 2 ml＋2.5 g dexmedetomidine;group Ⅲ：0.5% bupivacaine 2 ml＋5 g dexmedetomidine.To evaluate the effect of sensory blockade by acupuncture, recorded the onset and duration;the improved Bromage score was used to evaluate the effect of motor block non operative side of lower limb, record the onset and duration;after 1 -24 h were evaluated with VAS score. Results Three groups had no significant difference in the onset time of sensory block （P〉0.05）,group Ⅱ and Ⅲ were significantly prolonged duration of sensory block （P〈0.05 or P〈0.001）,in a dose-dependent manner; compared with group Ⅰ, group Ⅱ and Ⅲ group,the onset time of motor block was significantly shorter （P〈0.05 or P〈0.001）, group Ⅲ motor block maintenance time significantly increased （P〈0.01）;compared with group Ⅰ, group Ⅲ VAS score in postoperative 4 h and 8 h significantly decreased （P〈0.05 or P〈0.01）, in a dose-dependent manner. Conclusion 5 g dexmedetomidine combined with bupivacaine intrathecal anesthesia for patients with significant advantages of unilateral lower extremity surgery.

关 键 词：右美托咪啶 布比卡因 鞘内 疼痛 

分 类 号：R971.3[医药卫生—药品]