右美托咪定注射液联合罗哌卡因注射液用于臂丛神经阻滞的临床研究

Clinical trial of dexmedetomidine injection combined with ropivacaine injection in the treatment of brachial plexus block

目的观察右美托咪定注射液联合罗哌卡因注射液用于臂丛神经阻滞的临床疗效及安全性。方法将92例尺桡骨骨折患者随机分为对照组和试验组,每组46例。对照组予以0.75%罗哌卡因10 m L进行麻醉;试验组予以0.8μg·kg^(-1)右美托咪定+0.75%罗哌卡因10 m L进行麻醉。比较2组患者的临床疗效、血清超氧化物歧化酶(SOD)、丙二醛(MDA)和碱性成纤维细胞生长因子(b FGF)水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的恢复时间分别为(342.26±46.73)和(564.50±61.48)min,起效时间分别为(14.61±2.16)和(18.36±2.53)min,差异均有统计学意义(均P<0.05)。术后,SOD分别为(64.61±7.21)和(50.37±6.91)U·mL^(-1),MDA分别为(6.50±0.75)和(8.95±1.04)nmol·mL^(-1),b FGF分别为(144.95±16.22)和(124.17±16.13)ng·L^(-1),差异均有统计学意义(均P<0.05)。2组患者的药物不良反应主要有恶心和心动过缓,试验组和对照组的总药物不良反应发生率分别为6.52%和10.87%,差异无统计学意义(P>0.05)。结论右美托咪定注射液联合罗哌卡因注射液用于臂丛神经阻滞的临床疗效确切,其能够调节血清SOD、MDA和b FGF水平,且不增加药物不良反应的发生率。

Objective To observe the clinical efficacy and safety of dexmedetomidine injection combined with ropivacaine injection in the treatment of brachial plexus block. Methods A total of 92 patients with ulnar radius fracture were randomly divided into control and treatment groups with 46 cases per group. Control group was given 0. 75% ropivacaine 10 mL for anesthesia. Treatment group was given 0. 8 μg · kg^（-1） dexmetomidine ＋ 0. 75% ropivacaine 10 m L for anesthesia. The clinical efficacy,the serum levels of superoxide dismutase（ SOD）,malondialdehyde（ MDA）,basic fibroblast growth factor（ b FGF）,and adverse drug reactions were compared between two groups. Results After treatment,the main indexes in treatment and control groups were compared： recovery time were（ 342. 26 ± 46. 73） and（ 564. 50 ± 61. 48） min,working time were（ 14. 61 ± 2. 16） and（ 18. 36 ± 2. 53） min,the differences were statistically significant（ all P〈0. 05）. After surgery,the main indexes in treatment and control groups were compared： SOD were（ 64. 61 ±7. 21） and（ 50. 37 ± 6. 91） U·mL^（-1）,MDA were（ 6. 50 ± 0. 75）and（ 8. 95 ± 1. 04） nmol · mL^（-1）,b FGF were（ 144. 95 ± 16. 22） and（ 124. 17 ± 16. 13） ng·L^（-1）,the differences were statistically significant（ all P〈0. 05）. The adverse drug reactions of two groups were nausea and bradycardia. The total incidences of adverse drug reactions in treatment and control groups were 6. 52% and 10. 87% without significant difference（ P〉0. 05）. Conclusion Dexmedetomidine injection combined with ropivacaine injection has a definitive clinical efficacy in the treatment of brachial plexus block,which can significantly regulate the levels of SOD,MDA and b FGF,without increasing the incidence of adverse drug reactions.