右美托咪定用于臂丛神经阻滞的临床观察

目的探讨右美托咪定复合利多卡因、罗哌卡因进行臂丛神经阻滞的麻醉效果及安全性。方法选取100例择期上肢手术患者,随机分为观察组和对照组各50例。入室后选择肌间沟入路进行臂丛神经阻滞,待寻找到异感后观察组应用右美托咪定复合利多卡因、罗哌卡因进行臂丛神经阻滞,对照组仅应用利多卡因、罗哌卡因。结果 （1）在T1、T2、T3时间点,观察组患者的MAP低于对照组,HR明显慢于对照组（P〈0.01）。（2）在T1、T2、T3时间点,观察组患者的OAA/S评分低于对照组（P〈0.05）。（3）观察组感觉阻滞、运动阻滞起效时间明显短于对照组,观察组感觉阻滞、运动阻滞持续时间较对照组明显延长,差异有统计学意义（P〈0.05）。结论右美托咪定复合利多卡因、罗哌卡因用于肌间沟臂丛神经阻滞,显著缩短了局麻药的感觉、运动阻滞起效时间,明显延长感觉、运动阻滞持续时间,增强了臂丛神经阻滞效果,同时无明显的呼吸抑制作用,使血流动力学更加稳定。

Clinical observation of brachial plexus given by block dexmedetomidine

Objective To discuss the clinical anesthetic effects and safety of brachial plexus block given by dexmedetomidine combined with lidocaine and ropivacaine. Methods One hundred cases of patients with selective upper limb operation were randomly divided into research group and control group, each group had 50 patients. Interscalene approach for brachial plexus block was chosen as modus operandi and research group patients were given dexmedetomidine, lidocaine and ropivacaine while control group patients were given lidocaine and ropivacaine after the sense of blocking after needling. Results （1） Statistically significant differences （P 0.01） existed in MAP and HR from time point T1, T2 and T3 where patients of research group showed lower MAP and slower HR. （2） Statistically significant differences （P 0.05） existed in OAA/S score from time point T1, T2 and T3 where patients of research group scored lower. （3） Statistically significant differences （P 0.05） existed in items like sensory and motor block onset time and duration time in which patients of research group showed shorter and longer time than patients in control group respectively. Conclusion Brachial plexus block given by dexmedetomidine combined with lidocaine and ropivacaine can significantly shorten sensory and motor block onset time caused by local anesthetic and extend sensory and motor block duration time, thus enhancing the clinical effects of brachial plexus block. Meantime it will not cause respiratory depression and can realize more stable hemodynamics.