右美托咪定联合罗哌卡因对上肢手术臂丛神经阻滞BIS值及镇痛效果的影响  

Effect of dexmedetomidine combined with ropivacaine on BIS value and analgesic effect of brachial plexus block in upper limb surgery

作　　者：林琳 蓝丽芳 LIN Lin;LAN Lifang(Department of Anesthesiology,Xiamen Hospital of Traditional Chinese Medicine,Xiamen,Fujian,361000,China)

机构地区：[1]厦门市中医院麻醉科,福建厦门361000

出　　处：《当代医学》2021年第29期28-30,共3页Contemporary Medicine

摘　　要：目的探讨右美托咪定联合罗哌卡因对上肢手术臂丛神经阻滞脑电双频指数(BIS)及镇痛效果的影响。方法回顾性分析2018年2月至2020年3月于本院行上肢手术的90例患者的临床资料,根据麻醉方法的不同分为对照组(罗哌卡因臂丛神经阻滞)和观察组(右美托咪定联合罗哌卡因臂丛神经阻滞),各45例。比较两组不同时间[注入麻药后即刻(T0)、手术15 min(T1)、手术30 min(T2)、手术60 min(T3)]BIS值及镇痛效果。结果T1、T2、T3时,两组BIS值均低于T0,差异有统计学意义(P<0.05),且观察组T1、T2、T3时BIS值均低于对照组,差异有统计学意义(P<0.05);术后1 h(T4)、术后3 h(T5)、术后6 h(T6),观察组VAS评分均低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定联合罗哌卡因可有效调节上肢手术臂丛神经阻滞BIS值,强化臂丛神经阻滞镇痛效果,值得临床推广运用。Objective To investigate the effects of dexmedetomidine combined with ropivacaine on bispectral index(BIS)and analgesic effect of brachial plexus block in upper limb surgery.Methods Clinical data of 90 patients who underwent upper limb surgery in our hospital from February 2018 to March 2020 were retrospectively analyzed.According to different anesthesia methods,they were divided into control group(ropivacaine brachial plexus block)and observation group(dexmedetomidine combined with ropivacaine brachial plexus block),with 45 cases in each group.BIS values and analgesia were compared between the two groups at different times immediately after anaesthetic injection(T0),15 min after operation(T1),30 min after operation(T2),60 min after operation(T3).Results At T1,T2 and T3,BIS values of the two groups were lower than T0,the difference was statistically significant(P<0.05),and BIS values of the observation group at T1,T2 and T3 were lower than that of the control group,the difference was statistically significant(P<0.05);VAS scores of the observation group were lower than those of the control group at 1 h(T4),3 h(T5)and 6 h(T6)after operation,and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine combined with ropivacaine can effectively regulate BIS value of brachial plexus block and enhance the analgesic effect of brachial plexus block,which is worthy of clinical application.

关 键 词：上肢手术 臂丛神经阻滞 右美托咪定 罗哌卡因 BIS值 镇痛效果 

分 类 号：R614[医药卫生—麻醉学]