右美托咪定或枸橼酸舒芬太尼作为佐剂复合罗哌卡因对超声定位下锁骨上臂丛神经阻滞的影响  

Effect of dexmedetomidine or sufentanil citrate as adjuvant combined with ropivacaine on ultrasound-guided supraclavicular brachial plexus block

作　　者：杨爱萍[1] 李轶[1] 黄生辉[1] Yang Aiping;Li Yi;Huang Shenghui(Department of Anesthesiology,Lanzhou University Second Hospital,Lanzhou 730030)

机构地区：[1]兰州大学第二医院麻醉科,甘肃兰州730030

出　　处：《中国现代医药杂志》2021年第7期22-26,共5页Modern Medicine Journal of China

摘　　要：目的探讨右美托咪定或枸橼酸舒芬太尼作为佐剂复合罗哌卡因对超声定位下锁骨上臂丛神经阻滞的影响。方法选择行上肢手术患者90例,随机分为对照组(N组)、右美托咪定组(D组)和枸橼酸舒芬太尼组(S组),每组30例。患者均在超声引导下行锁骨上臂丛神经阻滞。D组采用0.375%罗哌卡因20ml加入右美托咪定1μg/kg(1ml),S组采用0.375%罗哌卡因20ml加入舒芬太尼0.2μg/kg(1ml),N组采用0.375%罗哌卡因20ml加入1ml生理盐水。观察感觉神经和运动神经阻滞的起效时间、维持时间及术后镇痛时间,并记录术中不同时间的心率(HR)、平均动脉压(MAP)和Richmond躁动-镇静(RASS)评分以及术中不良反应的发生情况。结果与N组比较,D组和S组感觉神经和运动神经阻滞时间、术后镇痛时间长,同时HR和MAP明显降低,差异均有统计学意义(P<0.05);与N组和S组比较,D组的感觉和运动神经阻滞的起效时间短,差异有统计学意义(P<0.05);3组手术前后RASS镇静评分差异无统计学意义(P>0.05);术中恶心呕吐、心动过缓等不良反应发生率比较差异无统计学意义(P>0.05)。结论罗哌卡因复合右美托咪定或枸橼酸舒芬太尼均可延长感觉神经和运动神经阻滞时间和术后镇痛时间,但前者可以缩短麻醉起效时间。Objective To investigate the effect of dexmedetomidine or sufentanil citrate as adjuvant combined with ropivacaine on ultrasound-guided supraclavicular brachial plexus block.Methods 90 patients with upper limb surgery were randomly divided into control group(group N),dexmedetomidine group(group D)and sufentanil citrate group(group S),30 cases in each group.All patients underwent ultrasound-guided supraclavicular brachial plexus block.Patients in group D accepted 0.375%ropivacaine 20 ml with dexmedetomidine 1μg/kg(1 ml),group S accepted 0.375%ropivacaine 20 ml with sufentanil 0.2μg/kg(1 ml),group N accepted 0.375%ropivacaine 20 ml with 1 ml saline.Observed the onset and maintenance time of sensory and motor block,the duration of postoperative analgesia,the Richmond Agitation and Sedation Scale,and the incidence of intraoperative adverse reactions.Results Compared with group N,the sensory and motor block time,postoperative analgesia time were longer,heart rate and mean arterial pressure of group D and group S were significantly lower(P<0.05).Compared with group N and group S,the onset time of sensation and movement in group D was shorter(P<0.05);there was no significant difference in the RASS sedation score among the three groups(P>0.05);there was no significant difference in adverse reactions such as nausea,vomiting and bradycardia during operation(P>0.05).Conclusion Ropivacaine combined with dexmedetomidine or sufentanil citrate can prolong the time of sensory and motor block and postoperative analgesia,but the former can shorten the onset time of anesthesia.

关 键 词：臂丛神经阻滞 右美托咪定 舒芬太尼 罗哌卡因 

分 类 号：R614[医药卫生—麻醉学]