右美托咪定在臂丛神经阻滞中的应用效果  

Effect of Dexmetomidine on Brachial Plexus Block

作　　者：曹锐 王育斌[1] 邱卫华 徐尤年 Cao Rui;et al(Department of Physiology and Patholhysiology ,Wuhan University of Science and Technology Medical College ,Wuhan 43006)

机构地区：[1]武汉科技大学医学院生理与病理生理学系,武汉430065 [2]武汉市新洲区人民医院麻醉科 [3]华中科技大学同济医学院附属协和医院麻醉科

出　　处：《数理医药学杂志》2018年第5期733-735,共3页Journal of Mathematical Medicine

摘　　要：目的:评价右美托咪定(dexmedetomidine,DEX)作为局部辅助用药在臂丛神经阻滞中的安全性和有效性。方法:选择臂丛神经阻滞后行桡骨骨折切开复位内固定术的患者90例,随机分为3组:罗哌卡因组(对照组,A组)、罗哌卡因+肾上腺素组(B组)和罗哌卡因+DEX组(C组),每组30例;比较感觉阻滞起效时间,感觉及运动阻滞持续时间,镇痛持续时间,给药前后不同时间点血压和心率变化。结果:与A组比较,B和C组在感觉阻滞起效时间缩短(P<0.05),感觉阻滞、运动阻滞以及镇痛持续时间显著延长(P<0.05);与A组比较,B组患者心率显著升高(P<0.05)而血压的变化较小;C组患者血压下降、心率减慢,变化的幅度分别为5.1%~8.9%和10.1%~15.2%。结论:DEX可作为局部辅助用药应用于臂丛神经阻滞,具有较好镇痛效果,其导致的血压下降和心率减慢在安全可控的范围内。Objective：To evaluate the efficacy and safety of dexmedetomidine（DEX）as an adjuvant in brachial plexus block.Methods：90 patients with radial fracture after brachial plexus block were randomly divided into ropivacaine group（control group,group A）,ropivacaine and epinephrine group（group B）,and ropivacaine and DEX group（group C）,with 30 cases in each group.The onset time of sensory block,the duration of sensory and motor block,the duration of analgesia,the changes of blood pressure and heart rate at different time points before and after administration were compared.Results：Compared with group A,the onset time of sensory block in group B and C was shorter than that in group A（P〈0.05）,and the sensory block,motor block and analgesia prolonged significantly（P〈0.05）.Compared with group A,heart rate increased significantly in group B（P〈0.05）,but the blood pressure changed little.In group C,blood pressure decreased,heart rate slowed down,and the range of changes was between 5.1%~8.9%and 10.1%~15.2%,respectively.Conclusion：DEX can be used as a local adjuvant in brachial plexus block,with good analgesic effect,and the decrease in blood pressure and heart rate caused by it is within a safe and controllable range.

关 键 词：神经阻滞 右美托咪定 肾上腺素 

分 类 号：R614[医药卫生—麻醉学]