摘要
目的:评价右美托咪定的镇静作用对慢性肾功能衰竭患者动静脉造瘘时臂丛神经阻滞麻醉的影响。方法:选取慢性肾功能衰竭行前臂动静脉造瘘患者28例,实施肌间沟臂丛神经阻滞,将其中行臂丛阻滞成功患者26例分为两组,分别接受右美托咪定(D组)和咪达唑仑(M组)持续静脉泵注镇静治疗,评价两组患者的镇静前、给药后10,20和30 min的HR、MAP、RR、SPO_2和术中镇静效果、术后镇痛药需要量,以及感觉与运动阻滞持续时间。结果:D组患者给药后各时间点HR、MAP值明显低于基础值和M组(P<0.05);RR及SPO_2在给药前后和两组间的比较其差异无统计学意义;D组患者的运动及感觉阻滞持续时间、第1次服用镇痛药时间明显长于M组(P<0.05),术后24 h镇痛药需要量明显少于M组(P<0.05)。结论:右美托咪定可以延长慢性肾功能衰竭患者的臂丛神经阻滞时间,并且提供良好的镇静、镇痛效果。
Objective： To study the clinical effect of dexmedetomidine sedation on brachial plexus block anesthesia in patients with chronic renal failure built in arteriovenous fistula. Methods： A interscalene brachial plexus block was performed in 28 patients scheduled for an arteriovenous fistula formnation. A successful block was achieved in 26 patients. 26 patients were divided into two groups, received either dexmedetomidine （group D, loading dose 1 μg/kg 10 rain fol- lowed by infusion or midazolam. HR, MAP, RR and SpO2 were recorded and compared between two groups during operation. The duration of the motor and sensory block was assessed. The time to first request for postoperative analgesia and Postoperative analgesic requirements in 24 h also were recorded. Results： HR and MAP of group D were lower than those in group M obviously（P〈0.05）. RR and SpO2 were similar between two groups. The motor and sensory block were longer in the dexmedetomidine group（P〈0.01）, respectively. Dexmedetomidine also increased the time of first request Ibr postoperative analgesia （P〈0.01 compared with midazolam and saline） and decreased analgesic requirements （P〈 0.05）. Conclusion： A systemic administration of dexmedetomidine prolongs the duration of brachial plexus block in chronic renal failure patients, and It also provided sedation and additional analgesia.
出处
《抗感染药学》
2015年第6期863-866,共4页
Anti-infection Pharmacy
