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作 者:马正红 MA Zheng-hong(Department of Anesthesia,Dawa District First People’s Hospital,Panjin 12420,China)
机构地区:[1]辽宁省大洼区第一人民医院麻醉科
出 处:《中国实用医药》2019年第33期15-17,共3页China Practical Medicine
摘 要:目的研究B超引导臂丛阻滞麻醉中右美托咪定的应用效果、最佳剂量与不良反应。方法90例B超引导臂丛阻滞麻醉的患者,随机分为实验1组、实验2组和实验3组,各30例。实验1组行麻醉诱导前静脉输注右美托咪定0.8μg/kg,实验2组输注0.4μg/kg,实验3组输注0.9%的氯化钠注射液。观察记录三组患者的手术情况,对比不良反应、手术时间及手术结束时麻醉维持时间各阶段的平均动脉压(MAP)、心率(HR)以及镇静(Ramsay)评分。结果实验1组负荷量泵注完毕后进行麻醉开始前(T1)~手术结束时(T6)时Ramsay评分高于入室后(T0)时,MAP及HR低于T0时,实验2组在T1~T6时Ramsay评分高于T0时,HR低于T0时;实验3组在T1~手术切皮时(T3)时MAP和HR均高于T0时;差异具有统计学意义(P<0.05)。实验3组在T1~T6时Ramsay评分低于实验1组和实验2组,MAP和HR高于实验1组和实验2组,差异具有统计学意义(P<0.05)。实验1组出现总不良反应发生率为80.0%高于实验2组和试验3组的26.7%、26.7%,差异有统计学意义(P<0.05)。结论B超引导臂丛阻滞麻醉中右美托咪定的应用剂量为0.4μg/kg,并且持续剂量0.4μg/(kg·h)时麻醉效果最佳,值得借鉴与推广。Objective To study the application effect,optimal dosage and adverse reactions of dexmedetomidine in ultrasound-guided brachial plexus block anesthesia.Methods A total of 90 cases of ultrasound-guided brachial plexus block anesthesia were randomly divided into experimental group 1,experimental group 2 and experimental group 3,with 30 cases in each group.Experimental group 1 received intravenous infusion of 0.8μg/kg dexmedetomidine before anesthesia induction,experimental group 2 received intravenous infusion of 0.4μg/kg dexmedetomidine,and experimental group 3 received intravenous infusion of 0.9%sodium chloride injection.The surgical condition was observed and recorded,and occurrence of adverse reactions,operation time,and mean arterial pressure(MAP),hear rate(HR)and Ramsay score at different time points was compared among three groups.Results In experimental group 1,the Ramsay score at after the completion of load pumping and before anesthesia(T1)-immediately after operation(T6)was higher than those at after entering the operating room(T0),and MAP and HR was lower than those at T0.In experimental group 2,the Ramsay score at T1-T6 was higher than those at T0,and HR was lower than those at T0.In experimental group 3,the MAP and HR at T1-skin incision(T3)was higher than those at T0.Their difference was statistically significant(P<0.05).The Ramsay score at T1-T6 in experimental group was lower than those in experimental group 1 and experimental group 2,and MAP and HR was higher than those in experimental group 1 and experimental group 2.Their difference was statistically significant(P<0.05).The incidence of adverse reactions was 80.0%in experimental group 1,which was higher than 26.7%and 26.7%in experimental group 2 and experimental group 3,and their difference was statistically significant(P<0.05).Conclusion In ultrasound-guided brachial plexus block anesthesia,0.4μg/kg dexmedetomidine with 0.4μg/(kg·h)maintenance anesthesia shows best anesthesia effect,and it is worthy of reference and promotion.
关 键 词:B超引导臂丛阻滞麻醉 右美托咪定 应用剂量
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