右美托咪定臂丛阻滞对全麻下肩关节镜手术中控制性降压及细胞因子的影响  

Effect of Dexmedetomidine Brachial Plexus Block on Controlled Hypotension and Cytokines During Shoulder Arthroscopy Under General Anesthesia

作　　者：刘琳 LIU Lin(Department of Anesthesiology,Jianhu Clinical Medical College of Yangzhou University(Jianhu County People's Hospital),Yancheng,Jiangsu Province,224700 China)

机构地区：[1]扬州大学建湖临床医学院(建湖县人民医院)麻醉科,江苏盐城224700

出　　处：《系统医学》2022年第21期102-105,共4页Systems Medicine

基　　金：盐城市科技计划项目(YK2019073)。

摘　　要：目的 探讨对全麻下肩关节手术者予右美托咪定臂丛神经阻滞对其控制性降压以及细胞因子的影响。方法 选择2019年10月—2021年10月建湖县人民医院收治的行关节镜下肩袖修补术患者40例为研究对象,以随机数表法分为对照组(n=20,采用罗哌卡因臂丛阻滞复合全麻)与观察组(n=20,采用右美托咪定联合罗哌卡因臂丛阻滞复合全麻),比较两组术前、术中血流动力学指标[平均动脉压(MAP)、心率(HR)],评估患者术前、术后炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-1β]水平,并评估患者术后不同时间节点疼痛评分(VAS)。结果 观察组术中MAP、HR水平分别为(68.95±4.54)mmHg、(62.04±3.54)次/min,均低于对照组,差异有统计学意义(t=4.264、2.763,P<0.05)。观察组术后TNF-α、IL-6、IL-1β水平分别为(29.71±3.12)、(85.43±5.84)、(18.25±2.35)pg/mL,均低于对照组,差异有统计学意义(t=3.774、3.376、20.332,P<0.05)。观察组术后1、2、4 h的VAS评分分别为(1.63±0.18)分、(1.89±0.27)分、(2.25±0.35),分,均低于对照组,差异有统计学意义(t=2.734、3.699、7.704,P<0.05)。结论 对全麻下肩关节镜手术者予右美托咪定臂丛神经阻滞能提高控制性降压效果,有利于减轻机体炎症应激反应以及患者术后疼痛程度。Objective To investigate the effect of brachial plexus block with dextrometolidine on controlled hypotension and cytokines in patients undergoing shoulder joint surgery under general anesthesia.Methods 40 patients who underwent arthroscopic rotator cuff repair in the Jianhu County People’s Hospital from October 2019 to October 2021were selected as the study subjects.They were randomly divided into the control group (n=20,ropivacaine brachial plexus block combined with general anesthesia) and the observation group (n=20,dexmedetomidine combined with ropivacaine brachial plexus block combined with general anesthesia).Compared the preoperative and intraoperative hemodynamic indexes[mean arterial pressure (MAP),heart rate (HR)]of the two groups,and evaluated the preoperative and postoperative inflammatory factors[tumor necrosis factor-α (TNF-α),Interleukin-6 (IL-6),IL-1β]and evaluated the VAS scores of patients at different time points after surgery.Results The intraoperative MAP and HR levels in the observation group were (68.95±4.54) mmHg and (62.04±3.54) beats/min,respectively,which were lower than those in the control group,and the difference is statistically significant (t=4.264,2.763,P<0.05).The postoperative TNF-α,IL-6 and IL-1β levels in the observation group were (29.71±3.12) pg/mL,(85.43±5.84) pg/mL and(18.25±2.35) pg/mL,respectively,which were lower than those in the control group,and the difference is statistically significant (t=3.774,3.376,20.332,P<0.05).The VAS scores of the observation group at 1,2 and 4 h postoperatively were (1.63±0.18) points,(1.89±0.27) point sand (2.25±0.35) points,respectively,which were all lower than those of the control group,and the difference is statistically significant (t=2.734,3.699,7.704,P<0.05).Conclusion The brachial plexus block with dexmedetomidine for shoulder arthroscopic surgery under general anesthesia can improve the effect of controlled hypotension,which is conducive to reducing the inflammatory stress reaction of the body and the degree of post

关 键 词：右美托咪定 臂丛阻滞 全麻 肩关节镜 控制性降压 细胞因子 

分 类 号：R614[医药卫生—麻醉学]