布托啡诺复合右美托咪定用于下肢神经阻滞麻醉的临床效果观察  

Clinical observation of butorphanol combined with dexmedetomidine for lower limb nerve block anesthesia

作　　者：姜红梅[1] 王海涛[1] JIANG Hong-mei;WANG Hai-tao(Baotou Central Hospital,Baotou 014030,China)

机构地区：[1]包头市中心医院,014030

出　　处：《中国实用医药》2024年第4期137-140,共4页China Practical Medicine

摘　　要：目的探讨在下肢神经阻滞麻醉中采用布托啡诺复合右美托咪定的临床效果。方法80例进行下肢手术的患者,采用随机数字表法分成对照组和研究组,每组40例。两组患者术中均采取下肢神经阻滞麻醉,对照组采用布托啡诺,研究组采用布托啡诺复合右美托咪定。对比两组麻醉阻滞时间,不同时间段(术前、神经阻滞期间、术后)心率、平均动脉压,手术前后应激指标[去甲肾上腺素(NE)、皮质醇(Cor)以及肾上腺素(E)],不良反应发生率。结果与对照组相比,研究组麻醉阻滞起效时间较短,麻醉阻滞持续时间、镇痛持续时间均较长(P<0.05)。神经阻滞期间,对照组心率为(86.54±4.15)次/min,平均动脉压为(93.54±4.34)mm Hg(1 mm Hg=0.133 kPa);研究组心率为(63.54±3.24)次/min,平均动脉压为(90.61±4.51)mm Hg,与对照组相比,研究组心率、平均动脉压较低(t=27.629、2.961,P<0.05)。术后,对照组心率为(73.54±3.34)次/min,平均动脉压为(97.55±5.12)mm Hg;研究组心率为(64.05±3.18)次/min,平均动脉压为(92.34±4.39)mm Hg,与对照组相比,研究组心率、平均动脉压较低(t=13.015、4.886,P<0.05)。术后,对照组NE为(451.25±25.12)ng/L,Cor为(844.15±31.15)nmol/L,E为(741.25±30.15)pmol/L;研究组NE为(344.85±24.05)ng/L,Cor为(721.35±28.46)nmol/L,E为(552.41±23.28)pmol/L,两组应激指标均较术前有所升高,但与对照组相比,研究组NE、Cor、E较低(t=19.350、18.407、31.354,P<0.05)。研究组不良反应发生率5.00%低于对照组的22.50%(P<0.05)。结论下肢神经阻滞麻醉中采用布托啡诺复合右美托咪定效果显著,可缩短麻醉阻滞时间,稳定术中应激指标,减少麻醉不良反应发生率,安全性较高。Objective To investigate the clinical effect of butorphanol combined with dexmedetomidine in lower limb nerve block anesthesia.Methods A total of 80 patients undergoing lower limb surgery were divided into a control group and a study group using a numerical table method,each with 40 cases.Lower limb nerve block anesthesia was performed in both groups during surgery,with butorphanol in the control group and butorphanol combined with dexmedetomidine in the study group.Both groups were compared in terms of anesthesia block time,heart rate and mean arterial pressure at different time periods(before surgery,during nerve block,after surgery),stress indicators[norepinephrine(NE),cortisol(Cor),and adrenaline(E)]before and after surgery,and incidence of adverse reactions.Results Compared with the control group,the onset time was shorter,and the duration of anesthesia block and duration of analgesia were longer in the study group(P<0.05).During nerve block,the heart rate of control group was(86.54±4.15)beats/min,and the mean arterial pressure was(93.54±4.34)mm Hg(1 mm Hg=0.133 kPa);the heart rate of the study group was(63.54±3.24)beats/min,and the mean arterial pressure was(90.61±4.51)mm Hg.Compared with the control group,the heart rate and mean arterial pressure in the study group were lower(t=27.629,2.961;P<0.05).After surgery,the heart rate of the control group was(73.54±3.34)beats/min,and the mean arterial pressure was(97.55±5.12)mm Hg;the heart rate of the study group was(64.05±3.18)beats/min,and the mean arterial pressure was(92.34±4.39)mm Hg.Compared with the control group,the heart rate and mean arterial pressure in the study group were lower(t=13.015,4.886;P<0.05).After surgery,the NE,Cor and E of the control group were(451.25±25.12)ng/L,(844.15±31.15)nmol/L and(741.25±30.15)pmol/L,and those of the study group were(344.85±24.05)ng/L,(721.35±28.46)nmol/L and(552.41±23.28)pmol/L.The stress indicators in both groups were higher than those before surgery,but NE,Cor and E in the study group were lower tha

关 键 词：下肢神经阻滞麻醉 布托啡诺 右美托咪定 平均动脉压 不良反应 

分 类 号：R614[医药卫生—麻醉学]