右美托咪定复合罗哌卡因在臂丛神经阻滞的的临床应用(1)
摘要：目的 探讨右美托咪定复合罗哌卡因在臂丛神经阻滞的临床应用。方法 选取2013年6月～2014年3月的上肢外伤患者56例，将56例患者随机分成两组，即R组(单独使用罗哌卡因药物麻醉组)和D组(复合使用右美托咪定和罗哌卡因药物麻醉组)。R组的28例患者麻醉时直接注射0.5%的罗哌卡因25 ml。D组的28例患者麻醉时采用复合型药物进行麻醉，患者注射0.5%的罗哌卡因25 ml和12.5 μg的右美托咪定溶液。分别在麻醉前(T0)，手术开始(T1)，手术开始后的30 min(T2)和手术结束(T3)后记录患者的心率(HR)，平均动脉血压(MAP)，氧饱和度(SpO2)。并且记录观察两组患者感觉和运动的阻滞效果和麻醉效果。结果 R组患者的心率在T1～T3时明显高于D组，D组的MAP在患者麻醉过后与R组比较有明显的降低。D组的感觉阻滞起效时间和运动阻滞起效时间均短于R组的时间，并且感觉和运动阻滞持续时间均长于R组，具有统计学意义(P<0.05)。两组患者的不良反应和术后的并发症均不明显。结论 右美托咪定复合罗哌卡因在臂丛神经阻滞的临床效果好，不良反应和术后并发症少。
关键词：右美托咪定；罗哌卡因；臂丛神经阻滞
Clinical Application of Dexmedetomidine Combined with Ropivacaine on Brachial Plexus Block
WANG Ming-hong
(Department of Anesthesiology，Ningde Hospital，Ningde 352100，Fujian，China)
Abstract：Objective To explore clinical application of dexmedetomidine combined with ropivacaine on brachial plexus block.Methods From June 2013toMarch 2014，56 patients were selection on upper limb trauma，56 patients were randomly divided into two groups，group R(single use ropivacaine)and group D(dexmedetomidine combined with ropivacaine).group R of 28 patients with anesthesia were treated with 25 ml of 0.5%of ropivacaine.Group D of 28 patients were treated with 25 ml of 0.5%of ropivacaine and 12.5μg dexmedetomidine.Before anesthesia(T0)，start(T1)，30 min(T2)and after the beginning of the operation after the end of surgery(T3)of the patient's heart rate(HR)，mean arterial blood pressure(MAP)，oxygen saturation(SpO2).Were investigated.Motor and sensory block onset times，block durations，and duration of analgesia were recorded.Results The group R of heart rate was significantly higher in T1-T3 than group D.The group D of MAP was significantly lower than group R after anesthesia.Motor and sensory block on set times in group D were significantly shorter than that in group R(P<0.05)，duration and motor block and sensory blockade perfect time were longer than the R group，there was statistically significantdifference(P<0.05).The adverse effects and postoperative complications was no significant difference between the two groups.Conclusion Dexmedetomidine combined with ropivacaine in brachial plexus block good clinical effect.
Key words：Dexmedetomidine；Ropivacaine；Brachial plexus block
临床上上肢的手术多采用臂丛神经阻滞的麻醉方法，但是，由于部分患者在麻醉后还有部分的意识存在，患者常产生恐惧，紧张的心理导致手术不能够顺利的进行[1]。右美托咪定是一种新型的，高选择性的α2受体激动剂，具有镇静，抗恐惧，抗紧张，降低应激反应，稳定血流动力学的作用[2]。相关研究报道右美托咪定复合局部麻醉药物能有效增加手术中患者的臂丛神经阻滞效果[3-5]。本研究将右美托咪定复合罗哌卡因对臂丛神经阻滞的临床效果进行研究和调查，现报告如下。
1资料与方法
1.1一般资料 选取2013年6月～2014年3月的上肢外伤患者56例，年龄为20～67岁，体重为49～70 kg，其中男患者30例，女患者26例。将56例患者随机分成两组，即R组(单独用罗哌卡因药物麻醉组)和D组(复合使用右美托咪定和罗哌卡因药物麻醉组)，每组28名患者。两组的患者在术前排除有严重心肺功能不全的患者，有高血压，糖尿病等慢性病史的患者，两组患者的一般资料差异不具有统计学意义(P>0.05)。本次实验研究经过医院伦理委员会的批准[6]，并且征得患者和患者家属的同意。, http://www.100md.com(王明虹)
关键词：右美托咪定；罗哌卡因；臂丛神经阻滞
Clinical Application of Dexmedetomidine Combined with Ropivacaine on Brachial Plexus Block
WANG Ming-hong
(Department of Anesthesiology，Ningde Hospital，Ningde 352100，Fujian，China)
Abstract：Objective To explore clinical application of dexmedetomidine combined with ropivacaine on brachial plexus block.Methods From June 2013toMarch 2014，56 patients were selection on upper limb trauma，56 patients were randomly divided into two groups，group R(single use ropivacaine)and group D(dexmedetomidine combined with ropivacaine).group R of 28 patients with anesthesia were treated with 25 ml of 0.5%of ropivacaine.Group D of 28 patients were treated with 25 ml of 0.5%of ropivacaine and 12.5μg dexmedetomidine.Before anesthesia(T0)，start(T1)，30 min(T2)and after the beginning of the operation after the end of surgery(T3)of the patient's heart rate(HR)，mean arterial blood pressure(MAP)，oxygen saturation(SpO2).Were investigated.Motor and sensory block onset times，block durations，and duration of analgesia were recorded.Results The group R of heart rate was significantly higher in T1-T3 than group D.The group D of MAP was significantly lower than group R after anesthesia.Motor and sensory block on set times in group D were significantly shorter than that in group R(P<0.05)，duration and motor block and sensory blockade perfect time were longer than the R group，there was statistically significantdifference(P<0.05).The adverse effects and postoperative complications was no significant difference between the two groups.Conclusion Dexmedetomidine combined with ropivacaine in brachial plexus block good clinical effect.
Key words：Dexmedetomidine；Ropivacaine；Brachial plexus block
临床上上肢的手术多采用臂丛神经阻滞的麻醉方法，但是，由于部分患者在麻醉后还有部分的意识存在，患者常产生恐惧，紧张的心理导致手术不能够顺利的进行[1]。右美托咪定是一种新型的，高选择性的α2受体激动剂，具有镇静，抗恐惧，抗紧张，降低应激反应，稳定血流动力学的作用[2]。相关研究报道右美托咪定复合局部麻醉药物能有效增加手术中患者的臂丛神经阻滞效果[3-5]。本研究将右美托咪定复合罗哌卡因对臂丛神经阻滞的临床效果进行研究和调查，现报告如下。
1资料与方法
1.1一般资料 选取2013年6月～2014年3月的上肢外伤患者56例，年龄为20～67岁，体重为49～70 kg，其中男患者30例，女患者26例。将56例患者随机分成两组，即R组(单独用罗哌卡因药物麻醉组)和D组(复合使用右美托咪定和罗哌卡因药物麻醉组)，每组28名患者。两组的患者在术前排除有严重心肺功能不全的患者，有高血压，糖尿病等慢性病史的患者，两组患者的一般资料差异不具有统计学意义(P>0.05)。本次实验研究经过医院伦理委员会的批准[6]，并且征得患者和患者家属的同意。, http://www.100md.com(王明虹)