探讨术中持续泵注右美托咪啶在臂丛神经阻滞麻醉上肢手术中的应用效果

目的探讨持续泵注右美托咪啶在臂丛神经阻滞麻醉上肢手术中的临床疗效。方法将2011年2月-2013年5月单侧上肢手术患者60例随机分为两组各30例，观察组采用术中持续泵注右美托咪啶复合臂丛神经阻滞麻醉，对照组则采用术中持续泵注生理盐水结合臂丛神经阻滞麻醉，比较两组患者在切皮、手术结束半小时后的疼痛情况及术中心率等监测指标。结果观察组在切皮及手术结束半小时后的视觉疼痛模拟评分（VAS）明显低于对照组患者（P〈0.05）；不过观察组患者术中出现了平均动脉压（MAP）降低及心率减慢的现象，减量后缓解。结论对上肢手术患者行术中持续泵注右美托咪啶符合臂丛神经阻滞麻醉效果较为满意，无抑制呼吸等不良反应，安全性较高，值得临床推广应用。

Exploring the intraoperative continuous infusion dexmedetomidine in the right brachial plexus anesthesia effect upper limb surgery

Objective To explore the clinical efficacy intraoperative continuous infusion of dexmedetomidine the right brachial plexus anesthesia in upper limb surgery. Methods From February 2011 to May 2013, 60 patients underwent unilateral upper extremity surgery were chosen in our hospital. They were randomly divided into control group and observation level group, the observation group were treated with intraoperative continuous infusion of dexmedetomidine pyridine complex brachial plexus anesthesia, while the control group using intraoperative continuous infusion of normal saline combined with brachial plexus anesthesia, two groups were compared in the incision, half an hour after the end of surgery pain conditions and differences in intraoperative heart rate and other basic indicators for monitoring changes. Results The patients in the surgical incision and a half hours after the end of the visual analogue pain scale（VAS） was significantly lower than the control group of patients（P〈0.05）; however observation group occurred in patients undergoing mean arterial pressure（MAP） and heart rate reduction reduces slow phenomenon, reduction remission. Conclusion Right upper extremity surgery intraoperative continuous infusion of dexmedetomidine meet the right brachial plexus anesthesia anesthesia with very satisfactory results, no inhibition of respiration and other adverse reactions, higher security, worthy of clinical application.