右美托咪定对老年左布比卡因腋路臂丛神经阻滞的影响

Effect of Dexmedetomidine Combined with Levobupivacaine on Axillary Brachial Plexus Block in the Elderly

观察右美托咪定对老年左布比卡因腋路臂丛神经阻滞的影响。50例择期行腋路臂丛神经阻滞的老年患者随机分为两组,右美托咪定组(LD组,25例)给予0.5%左布比卡因复合右美托咪定0.5μg·kg-130ml,生理盐水组(LS组,25例)给予0.5%左布比卡因复合生理盐水30ml。比较两组感觉运动阻滞起效时间、持续时间、心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)、Ramssay评分和不良反应。结果显示感觉和运动阻滞持续时间LD组显著长于LS组(P<0.05)。给药后各时点LD组HR慢于LS组(P<0.05),给药后10min、20min、30min、60min、90min和120minLD组MAP低于LS组(P<0.05),LD组Ramssay评分高于LS组(P<0.05)。右美托咪定复合0.5%左布比卡因在老年腋路臂丛神经阻滞中可显著延长感觉和运动阻滞的持续时间,提供良好镇静。

To investigate the effect of dexmedetomidine added to levobupivacaine on axillary brachial plexus block in the elderly. Fifty patients scheduled for elective forearm or hand surgery were selected and randomly divided into two groups, group LD and group LS. In group LD （n= 25）, dexrnedetomidine 0. 5μg · kg-1 was added into 30 ml of 0. 5% levobupivacaine and in group LS （n= 25）, normal saline was added into 30ml of 0.5 % levobupivacaine. Sensory and motor block onset time, block durations, MAP, HR, SpO2, Ramssay scores and adverse reactions were compared in two groups. Sensory and motor block durations in group LD were significantly longer than in group LS, （P〈0.05）. HRs in group LD were lower than is group LS after midication （P〈O. 05）, 10 min, 20 min, 30 rain, 60 min, 90 min and 120 min after midication MAPs in group LD were lower than in group LS （P〈0.05）, and Ramssay scores in group LD were higher than in group LS （P〈0.05）. Dexmedetomidine added to 0.5 % levobupivacaine in axillary brachial plexus block prolongs the duration of sensory and motor block and improves sedation in the elderly.