右美托咪定用于臂丛神经阻滞效果观察

目的观察右美托咪定用于肩关节镜手术中臂丛神经阻滞麻醉的麻醉效果。方法40例拟行肩关节镜手术患者按数字表法随机分为右美托咪定组（D组，n=20）和丙泊酚（P组，n=20），分别记录进入手术室、手术开始时、手术开始后15、30、45min和手术结束离开手术室时的平均动脉压（MAP）、脉搏氧饱和度（SpO：）、心率（HR）、BIS值，以及术后苏醒时间和术中芬太尼用量等指标。结果两组MAP比较，除了手术开始时其他时间点差异均无统计学意义（均P〉0．05）；各时间点D组HR都明显比P组慢（均P〈0．05）。两组各时间点BIS差异均无统计学意义（均P〉0．05）。D组术中芬太尼用量（61．2±22．3）μg、术后苏醒时间（27．4±5．3）min，与P组的（112．5±25．6）μg、（13．1±6．4）min差异均有统计学意义（均P〈0．05）。结论右美托咪定臂丛神经阻滞用于肩关节镜手术，能够提供平稳的麻醉状态，减少阿片类镇痛药的用量。

Effects of dexmedetomidine on brachial plexus block in arthroscopic shoulder surgery

Objective To observe the anesthetic effects of dexmedetomidine on brachial plexus block in ar- throscopic shoulder surgery. Methods 40 patients undergoing arthroscopic shoulder surgery were randomly divided into dexmedetomidine group （ group D, n = 20 ） and propofol group （ group P, n = 20 ）. The mean artery pressure （ MAP）, pulse oxygen saturation （ SpO2 ）, heart rate （ HR）, BIS, postoperative recovery time and intraoperative fentanyl consumption were recorded before operation, at the beginning of operation, after 15 minutes, 30 minutes, 45 minutes and leave the operation room. Results MAP had no significant differences between two groups at different time points （ P 〉 0.05 ）, except at the beginning of operation. HR of group D was significantly slower than group P （ P 〈 0.05 ）. BIS between the two groups had no significant difference （ P 〉 0.05 ）. The intraoperative fentanyl consumption and postoperative recovery time of group D were （61.2 ± 22.3 ） μg, （27.4 ± 5.3 ） min, those of group P were （ 112.5 ± 25.6）μg,（13.1 ±6.4）min,there were significant differences between two groups （P 〈0.05）. Conclusion Appli- cation of dexmedetomidine in brachial plexus nerve block for arthroscopic shoulder surgery, can provide stable anes- thesia, reduce the consumption of opioid analgesic.