南通大学学报（医学版）
南通大學學報（醫學版）
남통대학학보（의학판）
JOURNAL OF NANTONG UNIVERSITY(MEDICAL SCIENCES)
2014年
5期
377-379
,共3页
臂丛阻滞麻醉%右美托咪定%芬太尼
臂叢阻滯痳醉%右美託咪定%芬太尼
비총조체마취%우미탁미정%분태니
branchial plexus block anesthesia%dexmedetomidine%fentanyl
目的：探讨右美托咪定复合芬太尼辅助肌间沟臂丛阻滞麻醉的临床效果。方法：将36例择期臂丛麻醉下行上肢手术患者随机分为A组和B组：A组以0.375%罗哌卡因+芬太尼(10μg/mL)共20 mL行肌间沟臂丛阻滞麻醉；B组以0.375%罗哌卡因+右美托咪定(1μg/kg)+芬太尼(10μg/mL)共20 mL行肌间沟臂丛阻滞麻醉。在麻醉前(T0)、手术开始时(T1)、手术30 min时(T2)和手术结束时(T3)4个时间点记录患者心率(heart rate，HR)、平均动脉压(mean arterial pres-sure，MAP)、血氧饱和度(pulse oxygen saturation，SpO2)，警觉/镇静评分(observer’s assessment of alertness/sedation，OAA/S)，并记录两组患者麻醉起效时间、镇痛持续时间、运动恢复时间。结果：与A组比较，B组在T1、T2、T3时HR、MAP显著降低；B组在T1、T2、T3时OAA/S评分较低；B组麻醉起效时间缩短，镇痛持续时间和运动恢复时间延长(P<0.05)。心动过缓、呼吸抑制、恶心及呕吐等不良反应差异无统计学意义(P>0.05)。结论：右美托咪定复合芬太尼辅助臂丛阻滞麻醉可明显缩短麻醉起效时间，延长镇痛时间。
目的：探討右美託咪定複閤芬太尼輔助肌間溝臂叢阻滯痳醉的臨床效果。方法：將36例擇期臂叢痳醉下行上肢手術患者隨機分為A組和B組：A組以0.375%囉哌卡因+芬太尼(10μg/mL)共20 mL行肌間溝臂叢阻滯痳醉；B組以0.375%囉哌卡因+右美託咪定(1μg/kg)+芬太尼(10μg/mL)共20 mL行肌間溝臂叢阻滯痳醉。在痳醉前(T0)、手術開始時(T1)、手術30 min時(T2)和手術結束時(T3)4箇時間點記錄患者心率(heart rate，HR)、平均動脈壓(mean arterial pres-sure，MAP)、血氧飽和度(pulse oxygen saturation，SpO2)，警覺/鎮靜評分(observer’s assessment of alertness/sedation，OAA/S)，併記錄兩組患者痳醉起效時間、鎮痛持續時間、運動恢複時間。結果：與A組比較，B組在T1、T2、T3時HR、MAP顯著降低；B組在T1、T2、T3時OAA/S評分較低；B組痳醉起效時間縮短，鎮痛持續時間和運動恢複時間延長(P<0.05)。心動過緩、呼吸抑製、噁心及嘔吐等不良反應差異無統計學意義(P>0.05)。結論：右美託咪定複閤芬太尼輔助臂叢阻滯痳醉可明顯縮短痳醉起效時間，延長鎮痛時間。
목적：탐토우미탁미정복합분태니보조기간구비총조체마취적림상효과。방법：장36례택기비총마취하행상지수술환자수궤분위A조화B조：A조이0.375%라고잡인+분태니(10μg/mL)공20 mL행기간구비총조체마취；B조이0.375%라고잡인+우미탁미정(1μg/kg)+분태니(10μg/mL)공20 mL행기간구비총조체마취。재마취전(T0)、수술개시시(T1)、수술30 min시(T2)화수술결속시(T3)4개시간점기록환자심솔(heart rate，HR)、평균동맥압(mean arterial pres-sure，MAP)、혈양포화도(pulse oxygen saturation，SpO2)，경각/진정평분(observer’s assessment of alertness/sedation，OAA/S)，병기록량조환자마취기효시간、진통지속시간、운동회복시간。결과：여A조비교，B조재T1、T2、T3시HR、MAP현저강저；B조재T1、T2、T3시OAA/S평분교저；B조마취기효시간축단，진통지속시간화운동회복시간연장(P<0.05)。심동과완、호흡억제、악심급구토등불량반응차이무통계학의의(P>0.05)。결론：우미탁미정복합분태니보조비총조체마취가명현축단마취기효시간，연장진통시간。
Objective:To explore the clinical effects of dexmedetomidine and fentanyl assisted interscalene branchial plexus block on the upper limb operation. Methods: 36 patients with upper limb surgery were randomly divided into A group and B group. Patients of A group were administered with ropivacaine (0.375%)+fentanyl(10 μg/mL) and patients of B group were ad-ministered with ropivacaine(0.375%)+fentanyl(10 μg/mL)+dexmedetomidine(1 μg/kg). The heart rate(HR), mean arterial pres-sure(MAP), pulse oxygen saturation(SpO2) and observer’s assessment of alertness/sedation(OAA/S) were recorded at pre-anethesia(T0), surgery beginning(T1), post-surgery 30 min(T2) and the end of surgery(T3) four time point. The onset time of anesthesia, analgesia duration and exercise recovery time were recorded. Results: Compared with group A, HR and MAP of patients in the group B reduced significantly and OAA/S score dcreased at T1 , T2 and T3. The difference was statistically significant(P<0.05). Compared with group A, the onset time of anesthesia in group B decreased, analgesia duration and exer-cise recovery time in group B prolonged. The difference was statistically significant(P<0.05). The difference about adverse reactions ( bradycardia , respiratory depression , nausea and vomiting ) between two groups was not statistically significant ( P>0 . 05 ) . Conclusion:Dexmedetomidine and fentanyl assisted brachial plexus anesthesia can significantly shorten onset time of anesthesia, prolong duration of analgesia.
