CAJ | 학술논문

目的：本文评价右美托咪定和国产甲磺酸罗哌卡因混合用于臂丛（腋）神经阻滞的效果。方法：将50例拟行前臂或手部手术的病人以随机双盲法分为两组，每组25例。L-组：0．5％甲磺酸罗哌卡因35ml（175mg ）＋1ml生理盐水，LD-组：0．5％甲磺酸罗哌卡因35ml ＋1ml右美托咪定（75μg ）。监测和记录感觉和运动神经阻滞起效时间、作用时间和镇痛持续时间。结果：LD-组感觉和运动阻滞起效时间短于L-组（P＜0．05）。LD-组感觉和运动阻滞持续时间长于L-组（P＜0．01和 P＜0．001）。LD-组在阻滞后30、45、60、90和120 min时MAP显著低于L-组（P＜0．05）。LD-组HR在阻滞后15、30、45、60、90和120min时显著低于L-组（P＜0．05）。LD-组8例（32％）和L-组1例（4％）出现心动过缓使用了阿托品（χ2＝4．8780，P＜0．05）。结论：右美托咪定加入甲磺酸罗哌卡因中用于腋路臂丛神经阻滞，可缩短起效时间、延长阻滞和术后镇痛时间，同时可导致心动过缓。
목적：본문평개우미탁미정화국산갑광산라고잡인혼합용우비총（액）신경조체적효과。방법：장50례의행전비혹수부수술적병인이수궤쌍맹법분위량조，매조25례。L-조：0．5％갑광산라고잡인35ml（175mg ）＋1ml생리염수，LD-조：0．5％갑광산라고잡인35ml ＋1ml우미탁미정（75μg ）。감측화기록감각화운동신경조체기효시간、작용시간화진통지속시간。결과：LD-조감각화운동조체기효시간단우L-조（P＜0．05）。LD-조감각화운동조체지속시간장우L-조（P＜0．01화 P＜0．001）。LD-조재조체후30、45、60、90화120 min시MAP현저저우L-조（P＜0．05）。LD-조HR재조체후15、30、45、60、90화120min시현저저우L-조（P＜0．05）。LD-조8례（32％）화L-조1례（4％）출현심동과완사용료아탁품（χ2＝4．8780，P＜0．05）。결론：우미탁미정가입갑광산라고잡인중용우액로비총신경조체，가축단기효시간、연장조체화술후진통시간，동시가도치심동과완。
Objective:The aim of this study was to evaluate the effect of adding dexmedetomidine to Ropivacaine Mesy-late for axillary brachial plexus blockade .Methods:50 patients scheduled for elective forearm and hand surgery were di-vided into 2 equal groups in a randomized ,double-blind fashion .In group L (n=25) ,35ml (175mg) of 0 .5% Ropiva-caine Mesylate+1ml saline and in group LD(n=25) ,35ml of 0 .5% Ropivacaine Mesylate+1ml(75μg) dexmedetomi-dine were given .Motor and sensory block onset times ,block durations ,and duration of analgesia were recorded .Re-sults:Demographic data and surgical characteristics were similar in both groups .Sensory and motor block onset times were shorter in group LD than in group L(P<0 .05) .Sensory and motor blockade durations were longer in group LD than in group L(P<0 .01and P<0 .001) .Duration of analgesia was longer in group LD than in group L(P<0 .001) . MAP levels in group LD at 30 ,45 ,60 ,90 and 120 minutes were significantly lower than those in group L(P<0 .05) . Heart rate levels in group LD at 15 ,30 ,45 ,60 ,90 and 120 minutes were significantly lower than those in group L(P<0 .05) .In group LD bradycardia was observed in 8 patients ,and 1 patient in group L (P< 0 .05) .Conclusion:Dexme-detomidine added to ropivacaine mesylate for axillary brachial plexus block shortens the onset time and prolongs the du-ration of the block and the duration of postoperative analgesia .However ,dexmedetomidine also may lead to bradyca rdia .