静脉输注右美托咪定对超声引导下臂丛神经阻滞的影响  

Effect of Intravenous Dexmedetomidine on Ultrasound-guided Brachial Plexus Block

作　　者：马进[1] MA Jin(Department of Anesthesiology,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou,Zhejiang Province,310009 China)

机构地区：[1]浙江大学医学院附属第二医院麻醉科,浙江杭州310009

出　　处：《世界复合医学》2020年第6期68-70,共3页World Journal of Complex Medicine

摘　　要：目的探讨静脉输注右美托咪定对上肢手术超声引导下臂丛神经阻滞效果的影响。方法选取2018年10月—2019年10月在该院采用臂丛神经阻滞行上肢手术的患者80例(ASAⅠ~Ⅱ级),采用随机数字表法分为两组,分别为D组(右美托咪定组)和R组(对照组)。比较两组感觉和运动阻滞起效时间和持续时间,记录给予右美托咪定前(T0)、给药后10 min(T1)、给药后30 min(T2)、停药时(T3)及手术结束时(T4)的HR、MAP和SpO2,同时记录心动过缓、低血压、恶心呕吐等不良反应。结果与R组相比,D组患者感觉和运动阻滞持续时间明显长于R组[(672.4±92.9)min vs(586.1±71.5)min(t=4.331,P﹤0.01);(612.3±89.7)min vs(529.9±68.1)min](t=-4.205,P﹤0.01);在T2~T4时间点,D组心率明显慢于R组[(68.8±8.2)次/min vs(75.8±9.8)次/min(t=-3.49,P=0.001);(66.9±7.4)次/minvs(77.2±9.4)次/min(t=-5.665,P=0.000);(67.2±6.9)次/min vs(77.6±9.0)次/min(t=-6.291,P=0.000)],在T2~T3时间点,D组MAP明显低于R组[(81.0±8.8)mmHg vs(86.4±10.1)mmHg(t=-2.373,P=0.023);(80.3±7.5)mmHg vs(87.7±7.9)mmHg(t=-4.047,P=0.000)];所有患者围术期均未出现严重的不良反应或并发症。结论静脉应用右美托咪定能明显延长臂丛神经阻滞的感觉和运动阻滞持续时间,为上肢手术患者提供更好的镇痛。Objective To investigate the effect of intravenous infusion of dexmedetomidine on the effect of ultrasound-guided lower brachial plexus block in upper limb surgery.Methods From October 2018 to October 2019,80 patients(ASAⅠ~Ⅱ)who underwent upper limb surgery with brachial plexus block in our hospital were selected and divided into 2 groups using random number table method,respectively,group D(Dexmedetomidine group)and group R(control group).The onset time and duration of sensory and motor block were compared between the two groups,and the time before dexmedetomidine administration(T0),10 min after administration(T1),30 min after administration(T2),the time of withdrawal(T3)and at the end of the operation(T4),HR,MAP,and SpO2 were also recorded,including adverse reactions such as bradycardia,hypotension,and nausea and vomiting.Results Compared with group R,the duration of sensory and motor block in group D was significantly longer than that in group R[(672.4±92.9)min vs(586.1±71.5)min,(t=4.331,P<0.01);(612.3±89.7)min vs(529.9±68.1)min(t=-4.205,P<0.01)];at T2~T4,the heart rate of group D was significantly slower than that of group R[(68.8±8.2)times/min vs(75.8±9.8)times/min(t=3.490,P=0.001);(66.9±7.4)times/min vs(77.2±9.4)times/min(t=-5.665,P=0.000);(67.2±6.9)times/min vs(77.6±9.0)times/min),(t=-6.291,P=0.000)],at time T2~T3,the MAP of group D was significantly lower than that of group R[(81.0±8.8)mmHg vs(86.4±10.1)mmHg(t=-2.373,P=0.023);(80.3±7.5)mmHg vs(87.7±7.9)mmHg(t=-4.047,P=0.000)];all patients had no serious adverse reactions or complications during the perioperative period.Conclusion Intravenous dexmedetomidine can significantly prolong the sensation of brachial plexus block and the duration of motor block,and provide better analgesia for upper limb surgery patients.

关 键 词：上肢手术 臂丛神经阻滞 右美托咪定 

分 类 号：R614[医药卫生—麻醉学]