右旋美托咪啶复合丙泊酚用于小儿臂丛麻醉50例

目的 探讨丙泊酚复合右旋美托咪啶在神经刺激仪辅助定位臂丛神经阻滞下对行上肢手术患儿的麻醉效果及苏醒质量.方法 选取50例拟择期在臂丛神经阻滞麻醉下行上肢手术患儿为研究对象,将其随机分为实验组和对照组各25例.实验组在臂丛神经阻滞下采用丙泊酚复合右旋美托咪啶进行静脉麻醉,对照组在臂丛神经阻滞下单独采用丙泊酚静脉麻醉,两组患儿均在静脉诱导后,置入喉罩.观察记录两组患儿术前（T1）、手术切皮时（T2）、手术开始30 min （T3）各时间点的血压和心率,记录两组患儿丙泊酚用量、术后疼痛出现时间、停药后苏醒时间、术中体动、苏醒时躁动及术后嗜睡发生情况.结果 实验组患儿术中心率、血压明显较对照组稳定,丙泊酚用量明显少与对照组（P＜0.05）,苏醒时间缩短（P＜0.05）,术中体动、苏醒时躁动、术后嗜睡的发生率均明显低于对照组（P＜0.05）,术后镇痛时间较对照组明显延长（P＜0.05）.结论 丙泊酚复合右旋美托咪啶在臂丛神经阻滞下可为小儿上肢手术提供满意的麻醉效果,有利于患儿循环稳定,并可减少麻醉药用量,提高患儿术后苏醒质量,值得临床推广应用.

Propofol Combined with Dexmedetomidine in Pediatric Brachial Plexus Anesthesia with 50 Cases

Objective To study the effect and analepsia quality of propofol joint dexmedetomidine （DEX） on children performing upper limb surgery under braehial plexus block guided by nerve-stimulator. Methods 50 cases of children scheduled to perform upper limb surgery under brachial plexus block were randomized into experimental group and control group, with 25 cases in each group. The experimental group was given propofol combined with DEX for intravenous anesthesia under braehial plexus block, the control group was only given propofol for anesthesia under brachial plexus block. All the patients were inserted laryngeal mask after intravenous induction. BP, HR were recorded at the time of prior operation, incision and 30 min after operation. The propofol dosage, appeared time of postoperative pain, analepsia time after discontinuation, body movement during operation, restlessness and postoperative drowsiness of the two groups were recorded. Results BP and HR of the experimental group were more stable than those of the control group, the dosage of propofol of the experimental group was significantly lower than that of the control group （P〈0.05）; the awakening time of the experimental group shortened significantly （P 〈0.05）; the incidence of body movement, restlessness and postoperative drowsiness of the experimental group was significantly lower than that of the control group （P 〈0.05）; the postoperative analgesia time of the experimental group was significantly longer than that of the control group （P〈0.05）. Conclusions Propofol combined with DEX can improve the anesthesia efficacy for children performed upper limb surgery under brachial plexus block guided by nerve-stimulator, benefit patients＇ circulation stability, reduce the propofol dosage and improve the wake up quality, which is worthy of clinical application.