地塞米松复合氢吗啡酮用于肌间沟臂丛阻滞的效果观察  

Observation on the Effect of Dexamethasone Combined with Hydromorphone in Intermuscular Groove Brachial Plexus Block

作　　者：陶芳 Tao Fang(Department of Anesthesiology,Jiangyin Traditional Chinese Medicine Bone Injury Hospital,Jiangyin 214422,Jiangsu Province,China)

机构地区：[1]江阴市中医骨伤医院麻醉科,江苏江阴214422

出　　处：《中外医药研究》2025年第1期76-78,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:探讨地塞米松(DXM)复合氢吗啡酮(HM)用于肌间沟臂丛阻滞(ISBPB)的临床效果。方法:选取江阴市中医骨伤医院2022年10月—2024年3月收治的行上肢骨折切开复位内固定术的患者120例为研究对象,采用随机数字表法分为对照组、HM组和DXM复合HM组(DH组),每组40例。3组均接受超声引导下ISBPB,对照组应用罗哌卡因,HM组在对照组基础上联合HM,DH组在HM组基础上联合DXM。比较3组阻滞效果、术后疼痛情况、术后不良反应发生情况。结果:DH组及HM组感觉阻滞起效时间、运动阻滞起效时间短于对照组,且DH组短于HM组(P<0.05);DH组及HM组感觉阻滞维持时间、运动阻滞维持时间长于对照组,且DH组长于HM组(P<0.05)。术后12h、24h,DH组及HM组视觉模拟评分法评分均低于对照组,且DH组低于HM组(P<0.05)。DH组恶心呕吐发生率低于HM组和对照组(P<0.05)。结论:DXM复合HM用于ISBPB的效果显著,可提高麻醉效果,减轻术后疼痛,降低不良反应发生率。Objective:To investigate the clinical effect of dexamethasone(DXM)combined with hydromorphone(HM)on intermuscular groove brachial plexus block(ISBPB).Methods:A total of 120 patients who underwent open reduction and internal fixation of upper limb fractures in Jiangyin Traditional Chinese Medicine Bone Injury Hospital from October 2022 to March 2024 were selected as the study objects.They were divided into control group,HM group and DXM combined HM group(DH group)by random number table,with 40 cases in each group.All 3 groups received ultrasond-guided ISBPB,control group received ropivacaine,HM group was combined with HM group,DH group was combined with DXM group.The blocking effect,postoperative pain and postoperative adverse reactions were compared among the three groups.Results:The onset time of sensory block and motor block in DH and HM groups was shorter than that in control group,and DH group was shorter than that in HM group(P<0.05).The maintenance time of sensory block and motor block in DH and HM groups was longer than that in control group,and DH was longer than that in HM group(P<0.05).At 12 h and 24 h after surgery,the visual analog scale scores in DH group and HM group were lower than control group,and DH group was lower than HM group(P<0.05).The incidence of nausea and vomiting in DH group was lower than that in HM group and control group(P<0.05).Conclusion:DXM combined with HM is effective in ISBPB,which can improve the anesthetic effect,relieve postoperative pain and reduce the incidence of adverse reactions.

关 键 词：地塞米松 氢吗啡酮 肌间沟臂丛阻滞 

分 类 号：R614[医药卫生—麻醉学]