超声引导下低浓度罗哌卡因肌间沟臂丛神经阻滞结合右美托咪定在上肢骨折手术患者中的应用  

Application of Ultrasound-guided Low Concentration Ropivacaine Intermuscular Groove Brachial Plexus Block Combined with Dexmedetomidine in Patients Undergoing Upper Limb Fracture Surgery

作　　者：贺大江 HE Dajiang(Department of Anesthesiology,Qianxinan Prefecture Traditional Chinese Medicine Hospital,Xingyi 562400,China)

机构地区：[1]黔西南州中医院麻醉科,贵州兴义562400

出　　处：《中国医学创新》2025年第8期10-14,共5页Medical Innovation of China

摘　　要：目的:分析超声引导下低浓度罗哌卡因肌间沟臂丛神经阻滞结合右美托咪定在上肢骨折手术患者中的应用效果。方法:选取黔西南州中医院在2022年1月—2024年3月收取的60例上肢骨折手术患者,按随机数字表法分为两组,各30例。对照组采用超声引导下0.25%罗哌卡因肌间沟臂丛神经阻滞麻醉,观察组在对照组的麻醉方案上另采用右美托咪定。对比两组生命体征、麻醉阻滞效果、麻醉并发症等。结果:阻滞后10 min(T_(1))、30 min(T_(2))、60 min(T_(3))时对照组心率(HR)、平均动脉压(MAP)均较入室后(T_(0))有所降低,且均低于观察组,差异均有统计学意义(P<0.05);观察组T_(1)、T_(2)、T_(3)时HR、MAP相对稳定,较T_(0)时比较,差异均无统计学意义(P>0.05)。与对照组相比,观察组的起效时间缩短,感觉与运动阻滞时间均延长,差异均有统计学意义(P<0.05)。观察组麻醉阻滞优良率为100%,高于对照组的80.00%,差异有统计学意义(P<0.05)。两组麻醉并发症发生率比较,差异无统计学意义(P>0.05)。结论:对上肢骨折手术患者采用超声引导下低浓度罗哌卡因肌间沟臂丛神经阻滞结合右美托咪定,患者术中生命体征稳定,神经阻滞完善,神经阻滞时间延长。Objective:To analyze the application effect of ultrasound-guided low concentration Ropivacaine intermuscular groove brachial plexus block combined with Dexmedetomidine in patients undergoing upper limb fracture surgery.Method:Sixty patients with upper limb fracture surgery collected from Qianxinan Prefecture Traditional Chinese Medicine Hospital from January 2022 to March 2024 were selected and divided into two groups according to random number table method,with 30 patients in each group.The control group was anesthetized with ultrasound-guided 0.25%Ropivacaine interosseous groove brachial plexus block,and the observation group was additionally anesthetized with Dexmedetomidine on the anesthetic regimen of the control group.The vital signs,anesthesia block effect and anesthesia complications were compared between the two groups.Result:10 min(T_(1)),30 min(T_(2)),60 min(T_(3))after block,the heart rate(HR)and mean arterial pressure(MAP)of control group were lower than those after entry(T_(0)),the differences were statistically significant(P<0.05);HR and MAP in the observation group were relatively stable at T_(1),T_(2) and T_(3),there were no statistical significance compared with that at T_(0)(P>0.05).Compared with the control group,the time of onset of effect in the observation group was shorter,and the time of sensory and motor block were longer,the differences were statistically significant(P<0.05).The excellent and good rate of anesthesia block in the observation group was 100%,which was higher than 80.00%in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of anesthesia complications between the two groups(P>0.05).Conclusion:Ultrasound-guided low concentration Ropivacaine interosseous groove brachial plexus block combined with Dexmedetomidine in patients undergoing upper limb fracture surgery,patients'intraoperative vital signs are stable,nerve block is perfect,and the duration of nerve block is prolonged.

关 键 词：超声引导 低浓度 罗哌卡因 肌间沟臂丛神经阻滞 右美托咪定 上肢骨折 

分 类 号：R61[医药卫生—外科学]