摘要
目的探讨右美托咪定在臂丛神经阻滞麻醉上肢手术中的应用效果及对认知功能的影响。方法本次研究选取2015年5月~2016年5月期间60例在浙江省义乌復元私立医院行肘关节以下手术的患者作为对象。按照简单随机法将患者分为对照组（采用局麻药物复合生理盐水）、观察组（采用局麻药物复合右美托咪定）。比较2组患者麻醉前后平均动脉压及心率,麻醉情况及认知功能变化,以及不良反应发生情况。结果与麻醉前相比,2组患者麻醉后平均动脉压、心率明显降低（P〈0.05）;观察组患者麻醉后平均动脉压及心率明显高于对照组（P〈0.05）。2组患者运动阻滞剂感觉阻滞起效时间差异无统计学意义;而观察组运动阻滞及感觉阻滞维持时间明显长于对照组（P〈0.05）。对照组患者Ramsay评分低于3分者共有4例,构成比为13.33%观察组患者Ramsay评分低于3分者共有24例,构成比为80.00%,观察组镇静效果明显优于对照组（P〈0.05）。与麻醉前相比,2组患者术后20 min MMSE评分均有降低,但观察组患者MMSE评分明显高于对照组（P〈0.05）。2组患者不良反应发生情况差异无统计学意义。结论行肘关节以下手术时,采用局麻药物复合右美托咪定进行麻醉,可延长神经组织时间,且可获得较好的镇静、阵痛效果,且对患者认知功能影响较小。
Objective To explore the effect of dexmedetomidine on upper limb surgery during brachial plexus block anesthesia and its influence on cognitive function.MethodsFrom May 2015 to May 2016, 60 cases of elbow joint operation patients were studied.The patients were randomly divided into control group （local anesthesia combined with physiological saline） and observation group （using local anesthesia drugs with dexmedetomidine）.The mean arterial pressure and heart rate before and after anesthesia in two groups were compared.The changes of anesthesia and cognitive function, and the incidence of adverse reactions were compared between the two groups.ResultsCompared with before anesthesia, the mean arterial pressure and heart rate were significantly lower in the two groups （P〈0.05）.The mean arterial pressure and heart rate in the observation group were significantly lower than those in the control group （P〈0.05）.There was no significant difference between the two groups in the onset time of motor block sensory block, while the observation group was significantly longer than the control group （P〈0.05）.The control group patients with Ramsay score below 3 points, a total of 4 cases, accounting for the observation group of patients with Ramsay score of less than 3 points, a total of 24 cases, accounting for 80%, the observation group was significantly better than the control group （P〈0.05） sedative effect.Compared with before anesthesia, two groups of patients with postoperative 20min MMSE score were lower, but the observation group MMSE score was significantly higher than that of the control group （P〈0.05）.There was no significant difference in adverse reactions between the two groups.ConclusionIn the following surgery, the use of local anesthesia combined with dexmedetomidine anesthesia can prolong the time of nerve tissue, and can obtain better sedation and pain, and has little effect on the cognitive function of patients.
出处
《中国生化药物杂志》
CAS
2017年第5期359-361,共3页
Chinese Journal of Biochemical Pharmaceutics
关键词
右美托咪定
臂丛神经阻滞麻醉
上肢手术
认知功能
dexmedetomidine
brachial plexus block anesthesia
upper limb surgery
cognitive function
