不同剂量右美托咪定联合罗派卡因对臂丛神经阻滞效果和术后疼痛的影响  

Brachial plexus block effect and postoperative pain of different doses of dexmedetomidine combined with ropivacaine of patients

作　　者：石青青[1] 苏湘川[1] SHI Qing-qing;SU Xiang-chuan(Anesthesiology Depantment, Taizhou Municipal Hospital in Zhejiang Province, Taizhou 318000, China)

机构地区：[1]台州市立医院麻醉科,浙江台州318000

出　　处：《中国生化药物杂志》2017年第11期185-187,共3页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的观察在臂丛阻滞治疗中使用不同剂量右美托咪定与罗哌卡因联合治疗的临床疗效和术后疼痛的改善情况，探讨右美托咪与罗哌卡因的最佳配比剂量。方法选择台州市立医院100例择期行上肢手术患者，使用随机数字表法进行分组，将其分为A组和B1～B3组，每组各25例，对A患者使用浓度为0.5%的罗哌卡因进行注射治疗，B1～B3组患者均在A组患者的治疗基础上，分别加以0.6μg/kg、0.8μg/kg、1.0μg/kg的右美托咪定进行注射治疗。记录各组感觉和运动神经阻滞起效时间、持续时间、术中Ramsay镇静评分、术后VSA疼痛评分及不良反应发生情况。结果B1～B3组的感觉和运动神经阻滞起效时间相比于A组，明显较短，但药效时间增长，与B1组相比，B2、B3组的感觉和运动神经阻滞起效时间较短，但药效时间增长，组间数据对比差异具有统计学意义（P＜0.05）；Ramsay评分B1～B3组高于A组，B2、B3组高于B1组，组间比较差异具有统计学意义（P＜0.05）；术后10h及术后16hVSA疼痛评分，B1～B3低于A组，B2、B3组低于B1组，差异均具有统计学意义（P＜0.05）。结论将右美托咪定与罗哌卡因联合应用在臂丛神经阻滞治疗中，具有一定的安全性和有效性，能显著减轻患者术后疼痛，提高患者术后睡眠质量。Objective To explore the optimal dose of dexmedetom and ropivacaine by observing the block effect and postoperative pain of different doses dexmedetomidine combined with ropivacaine in patients with brachial plexus block.Methods In Taizhou Municipal Hospital one hundred patients undergoing upper limb operation were divided into ropivaeaine group(group A)and ropivacaine mixed with different doses of dexmedetomidine groups(group B1-B3)according to the random number table.Each group had25cases.In the group A,0.5%ropivacaine40mL was injected,while0.5%ropivacaine40mL mixed with different doses of dexmedetomidine were injected(0.6μg/kg in the group B1,0.8μg/kg in the group B2,1.0μg/kg in the group B3,respectively).The onset time of sensory and motor nerve block,the time of duration.Ramsay sedation score during operation,VSA score of postoperative pain and adverse reactions were compared among the groups.Results The onset time of sensory and motor nerve block in the groups B1-B3was shortened and the time of duration time was extended when compared to the group A.Moreover,the onset time in the group B2,B3was shortened and the duration time was extended when compared to the group B1.The diferences were also statistically significant(P<0.05).Ramsay sedation score in the groups B1-B3was higher than that in the group A,and the score in the groups B2and B3was higher than that in the B1,The diferences were also statistically significant(P<0.05).VSA pain score of10hours and16hours after surgery,B1-B3were lower than group A,B2and B3were lower than group B1,The diferences were also statistically significant(P<0.05).Conclusion It is safe and effective when use dexmedetomidine combined with ropivacaine in brachial plexus block,it can significantly reduce postoperative pain and improve sleep quality in patients of postoperative.

关 键 词：右美托咪定 罗派卡因 臂丛神经阻滞 

分 类 号：R614.4[医药卫生—麻醉学]