右美托咪定辅助臂丛阻滞麻醉在加速康复外科中的应用效果  

Effects of Dexmedetomidine Assisted Brachial Plexus Block Anesthesia on Enhanced Recovery after Surgery

作　　者：杨艳超[1] 蒋晨霞[1] 崔淑珍[1] 陈晶[1] 怀乔[1] 孟香果[1] YANG Yanchao;JIANG Chenxia;CUI Shuzhen;CHEN Jing;HUAI Qiao;MENG Xiangguo(Department of Anesthesiology,the First Hospital of Shijiazhuang,Shijiazhuang 050011,China)

机构地区：[1]石家庄市第一医院麻醉科,石家庄050011

出　　处：《解放军医药杂志》2018年第1期95-97,101,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：石家庄市科技计划(151460643)

摘　　要：目的探讨右美托咪定辅助臂丛阻滞麻醉在加速康复外科中应用的效果。方法选择石家庄市第一医院2015年11月—2016年6月于肌间沟臂丛阻滞麻醉下行上肢手术50例,按麻醉方法分为观察组和对照组,每组25例。麻醉成功后10 min,观察组静脉泵注右美托咪定,对照组应用适量咪达唑仑、芬太尼辅助镇静、镇痛。比较两组麻醉前(T0)、麻醉后10 min(T1)和手术开始后45 min时(T2)平均动脉压(MAP)、心率、肾上腺素(E)和去甲肾上腺素(NE)浓度的变化。记录术中不良反应发生情况。结果两组T1时点MAP、心率、E、NE水平均高于T0,T2时点均低于T0和T1时点,且观察组T2时点上述指标均低于对照组(P<0.05)。观察组无不良反应发生。结论右美托咪定辅助臂丛阻滞麻醉可有效抑制患者的应激反应,有利于患者快速康复。Objective To investigate effects of Dexmedetomidine assisted brachial plexus block anesthesia on enhanced recovery after surgery.Methods A total of 50 patients undergoing upper extremity surgery by intergroove brachial plexus block anesthesia during November 2015 and June 2016 were randomly divided into observation group and control group(n=25 for each group).At 10 min after successful anesthesia,observation group was injected with Dexmedetomidine by venous pump,while control group was assisted analgesia with appropriate doses of Midazolam combined with Fentanyl.Changes of mean arterial pressure(MAP),heart rate(HR),epinephrine(E)and norepinephrine(NE)concentrations were compared before anesthesia(T0),at 10 min after anesthesia(T1)and at 45 min after operation beginning(T2)in two groups.Condition of adverse reactions during the operation was recorded.Results In two groups,MAP,HR,E and NE levels at T1 were significantly higher than those at T1,while the levels at T2 were significantly lower than those at T0 and T1;in observation group,the above levels at T2 were significantly lower than those in control group(P<0.05).No adverse reaction was found in observation group.Conclusion Dexmedetomidine assisted brachial plexus block anesthesia may effectively inhibit stress reaction and accelerate recovery of patients.

关 键 词：右美托咪定 臂丛阻滞 麻醉 加速康复外科 

分 类 号：R614[医药卫生—麻醉学]