右美托咪啶在臂丛神经阻滞麻醉上肢手术中的应用

Application of dexmedetomidine on upper limb operation by brachial plexus nerve block anesthesia

目的观察术中持续泵注右美托咪啶在臂丛神经阻滞麻醉上肢手术中的应用效果。方法 40例择期行上肢手术患者分为右美托咪啶组和对照组。臂丛神经阻滞后10 min,右美托咪啶组患者静脉泵入右美托咪啶,对照组患者泵入生理盐水。记录麻醉前(T0)、臂丛神经阻滞后10 min(T1)、静脉给药后5(T2)、10(T3)、30(T4)、60 min(T5)及手术结束时(T6)患者的平均动脉压(MAP)、心率(HR)和动脉血氧饱和度(SpO2),并观察患者术中不良反应发生率,术后评估患者的麻醉满意度。结果 T0～T2时,2组患者MAP、HR及SpO2比较差异均无统计学意义(P>0.05);T3～T6时,右美托咪啶组患者MAP和HR显著低于对照组(P<0.05),但2组患者SpO2比较差异无统计学意义(P>0.05);右美托咪啶组T3～T6时患者MAP和HR显著低于T0时(P<0.05),对照组T3～T6时患者MAP和HR与T0时比较差异均无统计学意义(P>0.05);T0～T6时,2组患者SpO2比较差异均无统计学意义(P>0.05)。右美托咪啶组患者满意度显著高于对照组(P<0.05)。2组患者术中、术后均未出现恶心、呕吐等不良反应。结论在臂丛神经阻滞麻醉中持续泵注右美托咪啶,镇静镇痛效果更好,安全性高,患者术后满意度高。

Objective To observe the effect of dexmedetomidine′s continuous pump injection during upper limb operation by brachial plexus nerve block anesthesia.Methods A total of 40 patients who were treated with upper limb operation were divided into dexmedetomidine group and control group.Ten minutes after brachial plexus nerve block anesthesia,the dexmedetomidine was pumped into vein in dexmedetomidine group and the saline was pumped into vein in control group.The mean arterial pressure（MAP）,heart rate（HR） and arterial oxygen saturation（SpO2） were recorded at the points of before anaesthesia（T0）,10 minutes after brachial plexus nerve block（T1）,5（T2）,10（T3）,30（T4） and 60 min（T5）after intravenous administration and the end of the operation（T6）.Meanwhile adverse reactions rate of the patients in operation was observed,the degree of patients′ satisfaction on anesthesia was evaluated after operation.Results There was no significant difference in MAP,HR and SpO2 from T0 to T2 between the two groups（P0.05）;the MAP and HR from T3 to T6 in dexmedetomidine group were significantly lower than those in control group（P0.05）,but there was no significant difference in SpO2 between the two groups（P0.05）.In dexmedetomidine group,the MAP and HR from T3 to T6 were significantly lower than those of T0（P0.05）.MAP and HR of control group from T3 to T6 had no statistical significance compared with those of T0（P0.05）.There was no significant difference in SpO2 from T0 to T6 between the two groups（P0.05）.The degree of satisfaction of patients in dexmedetomidine group was remarkably higher than that in control group（P0.05）.Patients in the two groups had no any adverse reactions such as nausea and vomiting.Conclusion The dexmedetomidine′ continuous pumping in brachial plexus nerve block anesthesia has better sedative,analgesic effect and higher safety and degree of satisfaction.