上肢骨折手术患者右美托咪定辅助臂丛神经阻滞的效果

Efficacy of dexmedetomidine as an adjuvant to brachial plexus block for upper limb surgery

目的:探讨上肢骨折手术患者右美托咪定辅助臂丛神经阻滞的效果。方法:择期行桡骨骨折手术的50例患者随机分为两组,对照组采用臂丛神经阻滞;观察组在对照组基础上静脉泵注右美托咪定。对比两组患者麻醉起效及维持时间、术中止血带不耐受例数、切皮后10 min时MAP及HR变化、术后疼痛以及帕瑞昔布钠使用剂量。结果:与对照组比较,观察组患者感觉神经阻滞起效时间短,维持时间长,止血带不耐受例数少,切皮后MAP及HR变化值低,术后首次发生疼痛时间和镇痛效果持续时间长,帕瑞昔布钠使用剂量少(P<0.05)。结论:臂丛神经阻滞联合右美托咪定应用于桡骨骨折手术,能加快感觉神经阻滞起效时间,延长镇痛持续时间,维持术中血流动力学稳定,麻醉安全且效果显著。

Objective:To evaluate the effect of dexmedetomidine as an adjuvant for brachial plexus block in upper limb surgery.Methods:50 patients underwent radius surgery were divided into control group in which the patients were anesthetized by brachial plexus block only,and observation group in which the patients were treated with intravenous dexmedetomidine after brachial plexus block.After then,the onset and maintenance of surgical analgesia,the ratio of tourniquet intolerance,change of mean arterial pressure(MAP)and heart rate(HR)at 10 min following the start of surgery,the analgesia effect after surgery as well as the dose of Parecoxib sodium as the rescue analgesic were recorded.Results:Intravenous dexmedetomidine reduced the onset and increased the maintenance of brachial plexus block as comparing to the single brachial plexus block,in the meantime,this adjuvant also postponed the emergence of pain and prolonged the analgesia effect following surgery,and thus,decreased the dose of parecoxib sodium(P<0.05).Conclusion:Dexmedetomidine as the adjuvant can reduce the onset and increase the analgesia effect of brachial plexus block with stable perioperative circulation and,which is worthy introducing in clinical practice.