右美托咪定联合罗哌卡因对超声引导下臂丛神经阻滞效果的影响

Influence of dexmedetomidine combined with ropivacaine on brachial plexus blockunder ultrasound guidance

目的探讨右美托咪定联合罗哌卡因对超声引导下臂丛神经阻滞效果的影响。方法选择本院2016年12月7日至2018年4月16日收诊的超声引导下行臂丛神经阻滞患者54例,随机将其分为观察组和对照组,各27例。观察组给予罗哌卡因联合右美托咪定,对照组仅给予罗哌卡因。比较两组镇痛持续时长、运动阻滞维持时长、感觉阻滞维持时长、运动阻滞起效时长、感觉阻滞起效时长、手术室进入时(T0)、结束麻醉10 min(T1)、实施手术时(T2)、开展手术后30 min(T3)、结束手术时(T4)的镇静评分、心率(HR)与平均动脉压(MAP)、不良反应发生情况。结果观察组患者实施麻醉后的镇痛持续时长、运动阻滞维持时长、感觉阻滞维持时长均长于对照组(P<0.05);观察组运动阻滞起效时长与感觉阻滞起效时长均短于对照组(P<0.05)。观察组T1~T4的Ramsay评分均高于对照组(P<0.05)。观察组T1、T2的HR、MAP均高于对照组(P<0.05)。两组实施麻醉后的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论给予超声引导下臂丛神经阻滞患者右美托咪定联合罗哌卡因,可提高麻醉质量,减少不良反应,延长患者的镇痛持续时长,值得推广。

Objective To investigate the influence of dexmedetomidine combined with ropivacaine on brachial plexus block under ultrasound guidance.Methods From December 7,2016 to April 16,2018,54 patients with brachial plexus block under ultrasound guidance treated in our hospital were selected and randomly divided into observation group and control group,with 27 cases in each group.The observation group was given ropivacaine combined with dexmedetomidine,while the control group was only given ropivacaine.The duration of analgesia,duration of motor block,duration of sensory block,onset time of motor block,onset time of sensory block,the Ramsay scores,heart rates(HR)and mean arterial pressure(MAP)at time of entering operating room(T0),10 min after ending anesthesia(T1),time of performing operation(T2),30 min after operation(T3),time of ending operation(T4)and adverse reactions were compared between the two groups.Results The duration of analgesia,duration of motor block,duration of sensory block in the observation group were longer than those in the control group(P<0.05).The onset time of motor block,onset time of sensory block in the observation group were shorter than those in the control group(P<0.05).The Ramsay scores at T1-T4 in the observation group were higher than those in the control group(P<0.05).The HR and MAP at T1 and T2 in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the total incidences of adverse reactions between the two groups after anesthesia(P>0.05).Conclusion The combination of dexmedetomidine and ropivacaine applied to patients with brachial plexus block under ultrasound guidance can improve the quality of anesthesia,reduce the adverse reactions,and prolong the duration of analgesia of patients,which is worth popularizing.