摘要
目的探讨右美托咪定在臂丛神经阻滞中应用的临床效果。方法选择择期行上肢手术患者80例,随机分为罗哌卡因组(A组)和右美托咪定联合罗哌卡因组(B组),每组40例。患者在肌间沟处在神经刺激仪指引下给予药物,A组注入0.5%罗哌卡因15m L,B组注入0.5%罗哌卡因15m L复合右美托咪定0.6ug/kg。观察各组患者术侧感觉及运动阻滞起效时间、持续时间;比较两组患者入室时(T0)、给药后10min(T1)、手术开始时(T2)、手术结束时(T3)的HR、SPO2、MAP;同时记录两组患者不良反应发生情况。结果 A组患者感觉及运动阻滞起效时间明显长于B组,感觉及运动阻滞持续时间明显短于B组(P<0.05);B组T1、T2、T3时刻HR明显低于A组(P<0.05),CMAP差异无统计学意义;两组患者不良反应差异无统计学意义。结论右美托咪定联合罗哌卡因行臂丛神经阻滞可有效缩短感觉及运动阻滞的起效时间,延长感觉及运动阻滞的持续时间。
Objective To discuss the clinical effect of dexmedetomidine in brachial plexus block. Methods Choose 80 elective cases of upper extremity surgery and randomly divide them into ropivacaine( Group A) and dexmedetomidine combining with ropivacaine( Group B),40 cases in each group. Give the drug to the interscalene of the patients under the guidance of nerve stimulator. Inject 15 m L of 0. 5%ropivacaine into Group A and 15 m L of 0. 5% ropivacaine combining dexmedetomidine 0. 6 ug/kg into Group B. Observe the operative feeling and the onset time and duration of motor block; compare HR,SPO2 and MAP between two groups respectively when the patients entered the operating room( T0),10 minutes after the administration of drug( T1),at the beginning( T2) and at the end of the procedure( T3); record adverse reactions of two groups. Results The onset time of feeling and motor block of Group A is longer than that of Group B. The duration of feeling and motor block of Group A is shorter than that of Group B( P<0. 05); Group B has lower HR than Group A does at T1,T2 and T3( P<0. 05) and there is no statistical difference in CMAP between the two groups; there is no statistical difference in adverse reactions between the two groups. Conclusion Dexmedetomidine combining with ropivacaine in brachial plexus block can effectively shorten the onset time of feeling and motor block and prolong the duration of feeling and motor block.
