静脉输注右美托咪定在臂丛神经阻滞上肢手术老年患者中的应用效果

Application Effect of Intravenous Dexmedetomidine in Elderly Patients Undergoing Brachial Plexus Block Upper Limb Surgery

目的:分析在臂丛神经阻滞上肢手术中实施静脉输注右美托咪定的应用效果。方法:回顾性分析2018年10月-2019年9月福建医科大学附属闽东医院收治的80例臂丛神经阻滞上肢手术患者的临床资料,将实施静脉输注右美托咪定的40例患者作为研究组,将未实施静脉输注右美托咪定的40例患者作为对照组。比较两组感觉、运动阻滞起效时间和持续时间,比较两组各时间点的收缩压(SBP)、舒张压(DBP)、心率(HR)、视觉模拟评分法(VAS)评分及不良反应发生情况。结果:两组感觉阻滞、运动阻滞起效时间比较,差异无统计学意义(P>0.05);研究组感觉阻滞、运动阻滞持续时间明显长于对照组,差异有统计学意义(P<0.05)。研究组T_(2)~T_(4)时SBP、DBP和HR均低于对照组,差异有统计学意义(P<0.05)。T_(1)、T_(2)时,两组VAS评分比较,差异无统计学意义(P>0.05),T_(3)~T_(5)时,研究组VAS评分均显著低于对照组,差异有统计学意义(P<0.05)。研究组不良反应率与对照组比较,差异无统计学意义(P>0.05)。结论:静脉输注右美托咪定可延长臂丛神经阻滞上肢手术患者的感觉阻滞、运动阻滞持续时间,提高镇痛效果。

Objective:To analyze the application effect of intravenous Dexmedetomidine in elderly patients undergoing brachial plexus block upper limb surgery.Method:The clinical data of 80 elderly patients undergoing brachial plexus block upper limb surgery admitted to the Mindong Hospital Affiliated to Fujian Medical University from October 2018 to September 2019 were analyzed retrospectively.Among them,40 patients treated with intravenous infusion of Dexmedetomidine were selected as the study group,other 40 patients who did not treated with intravenous infusion of Dexmedetomidine were selected as the control group.The onset and duration of sensory block time and motor block time between the two groups were compared,and and the evaluation values of systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)and visual analogue score(VAS)score at each time point between the groups were analyzed.Result:There were no significant differences in the onset time of sensory block and motor block between the two groups(P>0.05).The duration of sensory block and motor block in the study group were significantly longer than that in the control group,and the differences were statistically significant(P<0.05).The SBP,DBP and HR in the study group were lower than those in the control group at T_(2)-T_(4),and the differences were statistically significant(P<0.05).There were no statistically significant differences in VAS scores between the two groups at T_(1) and T_(2)(P>0.05),but at T_(3)-T_(5),the VAS scores of the study group were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the adverse reaction rate between the study group and the control group(P>0.05).Conclusion:The intravenous infusion of Dexmedetomidine can prolong the sensory block and motor block time of elderly patients undergoing brachial plexus block upper limb surgery,improve the analgesic effect,and inhibit the intraoperative stress response.