右美托咪定用于臂丛神经阻滞麻醉上肢手术的效果及对患者认知功能的影响

Anesthesia Effect of Dexmedetomidine in Brachial Plexus Block Anesthesia of Upper Limb Surgery and Its Influence on Cognitive Function

目的:探讨右美托咪定用于臂丛神经阻滞麻醉上肢手术的效果及对患者认知功能的影响。方法:选取2015年7月—2017年7月江西省分宜县中医院收治的拟行臂丛神经阻滞麻醉上肢手术患者80例,以随机数字表法分为观察组和对照组,每组40例。对照组患者给予罗哌卡因联合利多卡因进行麻醉,观察组患者在对照组基础上加用右美托咪定。比较两组患者麻醉前后心率、平均动脉压,运动、感觉神经阻滞起效时间及维持时间和认知功能评分变化情况。结果:麻醉后40 min,两组患者心率、平均动脉压明显低于麻醉前10 min,但观察组患者明显高于对照组,差异均有统计学意义(P<0.05);两组患者运动、感觉神经阻滞起效时间的差异均无统计学意义(P>0.05);观察组患者运动、感觉神经阻滞维持时间明显长于对照组,差异均有统计学意义(P<0.05);麻醉前、术后48 h,两组患者认知功能评分的差异无统计学意义(P>0.05);术后0.5、24 h,观察组患者认知功能评分明显高于对照组,差异均有统计学意义(P<0.05)。结论:右美托咪定用于臂丛神经阻滞麻醉上肢手术的效果较好,可有效促进患者认知功能恢复。

OBJECTIVE： To probe into the anesthesia effect of dexmedetomidine in brachial plexus block anesthesia of upper limb surgery and its influence on cognitive function. METHODS： 80 patients undergoing brachial plexus block anesthesia of upper limb surgery admitted into the Jiangxi Fenyi County Traditional Chinese Medicine Hospital form Jul.2015 to Jul. 2017 were selected and divided into observation group and control group via random number table,with 40 cases in each. The control group was given ropivacaine combined with lidocaine for anesthesia,while the observation group was given dexmedetomidine based on the control group. Differences in heart rates and mean arterial pressures between two groups before and after anesthesia were compared,the onset time and maintenance time of motor nerve blocking and sensory nerve blocking,changes of scores of cognitive function of two groups were observed. RESULTS：40 min after anesthesia,the heart rates and mean arterial pressures of both groups were significantly lower than those of10 min before anesthesia,but those of the observation group were significantly higher than the control group,with statistically significant difference（ P〈0. 05）; there was no statistical significance in the difference of onset time of motor nerve blocking and sensory nerve blocking between two groups（ P〈0. 05）; the maintenance time of motor nerve blocking and sensory nerve blocking of the observation group was significantly longer than those of control group,with statistically significant difference（ P〈0. 05）; there was no statistical significance in the difference of score of cognitive function between two groups before and 48 h after anesthesia（ P〈0. 05）. At 0. 5 h and 24 h after anesthesia,score of cognitive function of observation group was significantly higher than that of the control group,with statistically significant difference（ P〈0. 05）. CONCLUSIONS： The anesthesia effect of dexmedetomidine in brachial plexus block anesthesia of upper limb surgery is remarkable,which can significantly promote the recovery of patients＇ cognitive function.