临床麻醉学杂志
臨床痳醉學雜誌
림상마취학잡지
THE JOURNAL OF CLINICAL ANESTHESIOLOGY
2014年
6期
546-549
,共4页
右美托咪定%罗哌卡因%臂丛神经阻滞
右美託咪定%囉哌卡因%臂叢神經阻滯
우미탁미정%라고잡인%비총신경조체
Dexmedetomidine%Ropivacaine%Brachial plexus block
目的：观察罗哌卡因复合右美托咪定对行喙突入路臂丛神经阻滞的影响。方法择期上肢手术患者60例,随机分成罗哌卡因组(R 组)和右美托咪定复合罗哌卡因组(RD 组),每组30例。患者在喙突内下2 cm 处,在神经刺激器引导下给予药物,R、RD 组分别给予罗哌卡因200 mg 及罗哌卡因200 mg 复合右美托咪定1μg/kg,容量均为40 ml。记录患者手术侧臂丛感觉和运动阻滞起效时间、感觉和运动阻滞持续时间。记录患者给药前、给药后15、30、60、90、120 min 的 HR、SBP、DBP 及 SpO2。同时记录 RD 组给药前和给药后30 min 非手术上肢的镇痛评分。记录两组患者不良反应发生情况。结果 R 组感觉、运动阻滞起效时间明显长于 RD 组,感觉、运动的阻滞持续时间明显短于 RD 组(P <0.01)；R 组给药后30、60、90、120 min 的 HR 明显快于、MAP 明显高于 RD 组(P<0.05)。RD 组给药前和给药后30 min 非手术上肢的镇痛评分差异无统计学意义。RD 组中有7例患者出现 HR 减慢,需要阿托品处理。结论罗哌卡因复合右美托咪定行臂丛神经阻滞可缩短臂丛神经的感觉、运动阻滞起效时间,延长感觉、运动阻滞持续时间。
目的：觀察囉哌卡因複閤右美託咪定對行喙突入路臂叢神經阻滯的影響。方法擇期上肢手術患者60例,隨機分成囉哌卡因組(R 組)和右美託咪定複閤囉哌卡因組(RD 組),每組30例。患者在喙突內下2 cm 處,在神經刺激器引導下給予藥物,R、RD 組分彆給予囉哌卡因200 mg 及囉哌卡因200 mg 複閤右美託咪定1μg/kg,容量均為40 ml。記錄患者手術側臂叢感覺和運動阻滯起效時間、感覺和運動阻滯持續時間。記錄患者給藥前、給藥後15、30、60、90、120 min 的 HR、SBP、DBP 及 SpO2。同時記錄 RD 組給藥前和給藥後30 min 非手術上肢的鎮痛評分。記錄兩組患者不良反應髮生情況。結果 R 組感覺、運動阻滯起效時間明顯長于 RD 組,感覺、運動的阻滯持續時間明顯短于 RD 組(P <0.01)；R 組給藥後30、60、90、120 min 的 HR 明顯快于、MAP 明顯高于 RD 組(P<0.05)。RD 組給藥前和給藥後30 min 非手術上肢的鎮痛評分差異無統計學意義。RD 組中有7例患者齣現 HR 減慢,需要阿託品處理。結論囉哌卡因複閤右美託咪定行臂叢神經阻滯可縮短臂叢神經的感覺、運動阻滯起效時間,延長感覺、運動阻滯持續時間。
목적：관찰라고잡인복합우미탁미정대행훼돌입로비총신경조체적영향。방법택기상지수술환자60례,수궤분성라고잡인조(R 조)화우미탁미정복합라고잡인조(RD 조),매조30례。환자재훼돌내하2 cm 처,재신경자격기인도하급여약물,R、RD 조분별급여라고잡인200 mg 급라고잡인200 mg 복합우미탁미정1μg/kg,용량균위40 ml。기록환자수술측비총감각화운동조체기효시간、감각화운동조체지속시간。기록환자급약전、급약후15、30、60、90、120 min 적 HR、SBP、DBP 급 SpO2。동시기록 RD 조급약전화급약후30 min 비수술상지적진통평분。기록량조환자불량반응발생정황。결과 R 조감각、운동조체기효시간명현장우 RD 조,감각、운동적조체지속시간명현단우 RD 조(P <0.01)；R 조급약후30、60、90、120 min 적 HR 명현쾌우、MAP 명현고우 RD 조(P<0.05)。RD 조급약전화급약후30 min 비수술상지적진통평분차이무통계학의의。RD 조중유7례환자출현 HR 감만,수요아탁품처리。결론라고잡인복합우미탁미정행비총신경조체가축단비총신경적감각、운동조체기효시간,연장감각、운동조체지속시간。
Objective To investigate the clinical effect of dexmedetomidine combined with ropi-vacanie in brachial plexus block (BPB)through modified coracoid approach.Methods Sixty patients scheduled for selective upper extremity surgery were randomly divided into two groups,30 patients in each group.BPB was performed at the point of 2 cm below coracoid directed by nerve stimulator. Ropivacaine (200 mg)was diluted into 40 ml in group R (n=30)and ropivacaine (200 mg)+1 μg/kg dexmedetomidine diluted into 40 ml in group RD (n=30).Motor and sensory block onset times and blockade durations were recorded.HR,SBP,DBP and SpO2 were recorded before drug administration and 1 5,30,60,90 and 120 min after drug administration.Visual Analog Scale (VAS)of normal up-per extremity in group RD was recorded before drug administration and 30 min after drug administra-tion.Side effects were recorded in both groups.Results Sensory and motor block onset time was sig-nificantly longer in group R than those in group RD;Sensory and motor blockade durations in group R was significantly shorter than in those group RD (P <0.01).Compared with group RD,MAP,HR at 30,60,90,120 minutes after drug administration were significantly higher in group R(P <0.05 ). VAS of normal upper extremity in group RD before drug administration and 30 min after drug admin-istration had no statistical significance.7 patients were treated with atropine for bradycardia in group RD.Conclusion Dexmedetomidine combined with ropivacaine for BPB shortens the sensory and motor block onset time and prolongs the duration of sensory and motor blockade.
