摘要
目的观察右美托咪定复合罗哌卡因臂丛神经阻滞对Narcotrend值的影响。方法 90例ASAⅠ或Ⅱ级需择期行上肢手术的患者,随机将患者均分为:臂丛神经阻滞注射0.375%罗哌卡因30 mL含右美托咪定1μg/kg组(RD1组)、臂丛神经阻滞注射0.375%罗哌卡因30 mL含右美托咪定1.5μg/kg组(RD2组)、臂丛神经阻滞注射0.375%罗哌卡因30 mL组(R组)。比较3组入室后(T0)、注药后2分钟(T1)、5分钟(T2)、10分钟(T3)、15分钟(T4)、30分钟(T5)的Narcotrend指数(NI)以及3组感觉阻滞持续时间、运动阻滞持续时间及镇痛持续时间。记录患者阻滞后30分钟内心动过缓、低血压、寒战、恶心呕吐等不良反应的发生情况。结果 3组患者在性别、年龄、体质量、身高、手术时间方面差异无统计学意义(P>0.05)。3组患者各时点MAP、HR、RR、SpO2的比较差异无统计学意义(P>0.05)。感觉和运动阻滞持续时间及镇痛时间RD1、RD2组均长于R组(P<0.05)。RD1、RD2组在T2、T3、T4、T5各时点的NI值均低于R组(P<0.05),RD1与RD2组组间各时点的NI值均无差异(P>0.05)。RD1组有5例患者发生心动过缓,RD2组有7例患者发生心动过缓,R组未有病例发生心动过缓。RD2组心动过缓的发生率大于R组(P<0.05)。所有患者均未出现低血压、寒战、恶心呕吐等不良反应。结论右美托咪定复合罗哌卡因在臂丛神经阻滞中有镇静作用,可延长阻滞持续时间及镇痛时间,但可能导致心动过缓。
Objective To evaluate the sedative effect of adding dexmedetomidine to levobupivacaine for brachial plexus blockade . Methods Ninety patients with ASA I orⅡ,scheduled for elective upper extremity surgery ,were randomly divided into three equal groups .In group RD1（n=30） patients were given 30ml of 0.375% ropivacaine and 1μg/kg Dex.In group RD2（n=30） patients were given 30ml of 0.375%ropivacaine and 1.5μg/kg Dex.In group R （n=30） patients were given 30ml of 0.375%ropivacaine.Changes in NI before anes-thesia（T0）,2 min（T1）,5 min（T2）,10 min（T3）,15 min（T4）,30 min（T5） after anesthesia were investigated.Motor and sensory block dura-tions time and duration of analgesia were recorded .The adverse effects of bradycardia ,shiver,hypopiesia,nausea and vomiting were recorded . Results Motor and sensory blockade durations were longer in group RD 1 and RD2 than those in group R（P〈0.05）.The duration of analge-sia time in group R was significantly shorter than that in the others （P〈0.05）.NI in group of RD1 and RD2 was lower than in group R at T2-T5（P〈0.05）,while there was no significant difference between the group of RD 1 and RD2.Bradycardia was found in group of RD1 and RD2 ,but none in group R .Conclusion Dexmedetomidine adding to ropivacaine for brachial plexus block can exert sedative effect ,and at the same time can prolong the duration of the block and the duration of postoperative analgesia .However ,it may lead to bradycardia .
出处
《安徽医学》
2014年第4期446-449,共4页
Anhui Medical Journal
