CAJ | 학술논문

目的：探讨右美托咪定在前臂骨折手术臂丛神经阻滞中的作用。方法：选择69例前臂骨折患者，手术均采用臂丛神经阻滞。纳入患者被随机分为三组，分别采用右美托咪定（A组）、咪达唑仑（ B组）和安慰剂（生理盐水、C组），比较三组不同时间点心率（ HR）、平均动脉压（ MAP ）、呼吸频率（ RR），记录三组患者手术前后的VAS评分并统计分析。结果：A组中随着麻醉和手术进展，心率、平均动脉压逐渐下降，在手术开始时、复位操作和手术结束时心率、平均动脉压均显著低于C 组。 B组患者于手术切皮时和复位操作时的呼吸频率较基础值显著降低，并且显著低于A组和C组（P 均＜0．05）。 A组、B组患者在手术开始前、手术结束时、手术后30min的VAS评分均显著低于C组（ P 均＜0．05），C组芬太尼使用量显著高于A组和B组（P均＜0．05）。结论：右美托咪定能有效地达到臂丛神经阻滞下前臂骨折手术的辅助镇痛效果，值得临床应用并推广。
목적：탐토우미탁미정재전비골절수술비총신경조체중적작용。방법：선택69례전비골절환자，수술균채용비총신경조체。납입환자피수궤분위삼조，분별채용우미탁미정（A조）、미체서륜（ B조）화안위제（생리염수、C조），비교삼조불동시간점심솔（ HR）、평균동맥압（ MAP ）、호흡빈솔（ RR），기록삼조환자수술전후적VAS평분병통계분석。결과：A조중수착마취화수술진전，심솔、평균동맥압축점하강，재수술개시시、복위조작화수술결속시심솔、평균동맥압균현저저우C 조。 B조환자우수술절피시화복위조작시적호흡빈솔교기출치현저강저，병차현저저우A조화C조（P 균＜0．05）。 A조、B조환자재수술개시전、수술결속시、수술후30min적VAS평분균현저저우C조（ P 균＜0．05），C조분태니사용량현저고우A조화B조（P균＜0．05）。결론：우미탁미정능유효지체도비총신경조체하전비골절수술적보조진통효과，치득림상응용병추엄。
Objective:To investigate the effect of dexmedetomidine in brachial plexus block for upper extremity fractures.Method:69 cases of patients with upper extremity fractures undertaken brachial plexus surgery were collected .Patients were divided into three groups , namely the usage of dexmedetomidine ( group A) , midazolam ( group B) and placebo ( saline , group C).Heart rate ( HR), mean arterial pressure (MAP) and respiratory rate (RR) in different points of time were compared in three groups .VAS scores be-fore and after surgery in three groups were recorded and statistical analysis was taken .Result:With the pro-gress of anesthesia and surgery , heart rate and mean arterial pressure in group A were decreased at the begin-ning of surgery , reset operation and at the end of surgery were significantly lower than group C .At the surgi-cal incision and reset operation in group B , respiratory rate was significantly reduced compared to baseline values, and significantly lower than in group A and group C ( P <0.05) .Before surgery , at the end of sur-gery and 30min after surgery , VAS scores in group A , group B were significantly lower than group C ( P <0.05).The amount of fentanyl in group C was significantly higher than group A and group B (P<0.05). Conclusion:Dexmedetomidine may effectively achieve assisted therapy in brachial plexus block analgesia for upper extremity fractures surgery , It's worthy of clinical application and promotion .