右美托咪定(Dex)联合臂丛神经阻滞麻醉在老年上肢骨折手术中的应用价值  

Application Value of Dexmedetomidine(Dex)Combined with Brachial Plexus Block Anesthesia in Elderly Upper Limb Fracture Surgery

作　　者：陈美杉 荣燕 郭政嘉 CHEN Meishan;RONG Yan;GUO Zhengjia(Department of Anesthesiology,Xinyi People′s Hospital,Xinyi,Jiangsu Province,221400 China)

机构地区：[1]新沂市人民医院麻醉科,江苏新沂221400

出　　处：《系统医学》2023年第6期111-114,共4页Systems Medicine

摘　　要：目的探究分析右美托咪定联合臂丛神经阻滞麻醉在老年上肢骨折手术中的应用价值。方法搜集2021年6月—2022年10月于新沂市人民医院行上肢骨折手术治疗的老年患者作为分析研究对象,共96例。按计算机随机分组法将对象分为干预组与观察组,各组48例。干预组采用生理盐水联合臂丛神经阻滞麻醉,观察组采用Dex联合臂丛神经阻滞麻醉。比较两组患者在不同时间节点的心率(heart-rate,HR)水平和平均动脉压(mean arterial pressure,MAP)水平,神经阻滞麻醉的起效时间和维持麻醉时间,不良反应总发生率。结果在给药前和给药后15 min,两组HR水平和MAP水平比较,差异无统计学意义(P>0.05);在给药后30、60、90 min观察组HR、MAP水平均低于干预组(P<0.05);观察组感觉神经阻滞麻醉、运动神经阻滞麻醉的起效时间均短于干预组,维持麻醉时间长于对照组,差异有统计学意义(P<0.05);观察组不良反应总发生率为6.25%与干预组的10.42%比较,差异无统计学意义(χ^(2)=0.136,P>0.05)。结论针对采取上肢骨折手术的老年患者,采取右美托咪定Dex联合臂丛神经阻滞麻醉的方式可有效延长运动、感觉神经阻滞时间,其心率和平均动脉压相对稳定,安全性良好,值得临床应用与推广。Objective To explore and analyze the application value of Dexmedetomidine combined with brachial plexus block anesthesia in elderly upper limb fracture surgery.Methods From June 2021 to October 2022,96 elderly patients with upper extremity fractures treated in Xinyi People′s Hospital were collected as study objects.According to computer random grouping method,the subjects were divided into intervention group and observation group,with 48 cases in each group.The intervention group received normal saline combined with brachial plexus block anesthesia,and the observation group received Dex combined with brachial plexus block anesthesia.The heart rate(HR)level and mean arterial pressure(MAP)level,the onset time and maintenance time of nerve block anesthesia,and the total incidence of adverse reactions were compared between the two groups at different time points.Results There was no statistically significant difference in HR and MAP levels between the two groups before and 15 minutes after administration(P>0.05);the levels of HR and MAP in the observation group were lower than those in the intervention group at 30,60,and 90 minutes after administration,the difference was statistically significant(P<0.05);the onset time of sensory nerve block anesthesia and motor nerve block anesthesia in the observation group were shorter than those in the intervention group,and the duration of maintenance anesthesia was longer than that in the control group,the difference was statistically significant(P<0.05);the total incidence of adverse reactions in the observation group was 6.25%,and there was no statistically significant difference compared to 10.42%in the intervention group(χ^(2 )=0.136,P>0.05).Conclusion For elderly patients undergoing upper limb fracture surgery,combined with brachial plexus block anesthesia can effectively prolong the motor and sensory nerve block time.Its heart rate and mean arterial pressure are relatively stable,and its safety is good,so it is worthy of application and promotion.

关 键 词：美托咪定 上肢骨折 手术 臂丛神经阻滞 心率 神经阻滞 

分 类 号：R614[医药卫生—麻醉学]