右美托咪定或咪达唑仑复合0.375%左旋布比卡因对超声引导下臂丛神经阻滞效果比较  

Comparison of adding dexmedetomidine or midazolam to 0.375% levobupivacaine in ultrasound-guided brachial plexus block

作　　者：陈海涛[1] 刘玉[1] 刘绍正 王先锋[1] CHEN Haitao;LIU Yu;LIU Shaozheng(Department of Anesthesiology,Wanbei Coal-Electric Group General Hospital,Suzhou 234011,China)

机构地区：[1]皖北煤电集团总医院麻醉科,安徽宿州234011

出　　处：《安徽医学》2017年第12期1533-1536,共4页Anhui Medical Journal

摘　　要：目的比较右美托咪定或咪达唑仑加入0.375%左旋布比卡因用于超声引导下臂丛神经阻滞效果。方法选择2014年1月至2016年12月皖北煤电集团总医院行前臂或手部手术的ASAⅠ~Ⅱ级患者120例,随机分为3组,每组40例。左旋布比卡因组(L组)接受0.375%左旋布比卡因30 m L,左旋布比卡因+咪达唑仑组(LM组)接受0.375%左旋布比卡因30 m L+咪达唑仑(50μg/kg),左旋布比卡因+右美托咪定组(LD组)接受0.375%左旋布比卡因30 m L+右美托咪定(1μg/kg)。评估痛觉和运动阻滞起效时间、痛觉和运动阻滞维持时间、镇痛时间以及不良反应。结果 3组患者的痛觉、运动阻滞起效时间、维持时间、镇痛时间差异有统计学意义(P<0.05)。与L组相比,LM组和LD组痛觉、运动阻滞起效时间缩短,痛觉、运动阻滞维持及镇痛时间延长,差异有统计学意义(P<0.05)。与LM组相比,LD组痛觉、运动阻滞起效时间缩短,痛觉、运动阻滞维持及镇痛时间延长,差异有统计学意义(P<0.05)。LM组患者的Ramsay镇静评分高于LD组,但差异无统计学意义(P>0.05)。3组患者的不良反应发生率差异无统计学意义(P>0.05)。结论右美托咪定、咪达唑仑复合左旋布比卡因用于超声引导下臂丛神经阻滞中,能缩短痛觉、运动阻滞起效时间,延长痛觉和运动阻滞维持时间及镇痛时间。相比咪达唑仑,右美托咪定的效果更好。ObjectiveTo assess the effectiveness of adding dexmedetomidine or midazolam to0.375%levobupivacaine on ultrasound-guided brachial plexus block MethodsA total of120ASA I to II patients with forearm and hand surgery under ultrasound-guided brachial plexus block in Wanbei Coal-Electric Group General Hospitalwere recruited in this study and randomly divided into three study groups(n=40in each),namely,Group L,which received30mL0.375%levobupivacaine,Group LM,which received30mL0.375%levobupivacaine with midazolam(50μg/kg),and Group LD,which received30mL0.375%levobupivacaine with dexmedetomidine(1μg/kg).The onset time,as well as the duration of sensory and motor block,the duration of analgesia and adverse events were recorded and evaluated.ResultsThe onset time,as well as the duration of sensory and motor block,the duration of analgesia had significant difference when the groups were compared(P<0.05).The onset of sensory and motor block was significantly faster in group LM and group LD compared to that in group L,and the difference was statistically significant(P<0.05).Time of administration of rescue analgesic,duration of sensory and motor block showed significant increase in group LD in comparison with group LM which showed significant increase in comparison with group L,and the difference was statistically significant(P<0.05).The Ramsay sedation score of group LM was higher in group LM than that in group LD without statistical significance(P<0.05),however.No significant difference was observed in the incidence of the adverse events when the groups were compared(P>005)Conclusiondexmedetomidine and midazolam in combination with levobupivacaine in ultrasound-guided brachial plexus block are effective in decreasing the onset of sensory and motor block and extending the duration of sensory and motor block and the timeto first analgesic request.In comparison with midazolam,the addition of dexmedetomidine to levobupivacaine is more effective.

关 键 词：右美托咪定 咪达唑仑 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]