肩关节镜手术中应用右美托咪定复合罗哌卡因行臂丛上干及颈浅丛神经阻滞的效果分析

目的分析肩关节镜手术中应用右美托咪定(Dex)复合罗哌卡因行臂丛上干及颈浅丛神经阻滞的效果。方法回顾性分析漯河医学高等专科学校第三附属医院2018年1月至2019年12月期间应用Dex复合罗哌卡因行肩关节镜手术治疗的患者70例的临床资料,依据麻醉方式进行分组,将行传统肌间沟臂丛神经阻滞的31例患者临床资料归为对照组,将行臂丛上干及颈浅丛神经阻滞的39例患者临床资料归为观察组,比较两组不同时间段的心率、平均动脉压及术后不同时间段的疼痛程度。结果两组患者术前心率、平均动脉压比较,差异无统计学意义(P>0.05);观察组术中5 min、术中30 min、喉罩拔除后30 min的心率均高于对照组,平均动脉压低于对照组(P<0.05);术后24 h,两组视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05);术后6 h、12 h时,观察组VAS评分低于对照组(P<0.05)。结论肩关节镜手术中应用Dex复合罗哌卡因行臂丛上干及颈浅丛神经阻滞的效果较好,可以缓解疼痛程度,且对心率影响较小。

Effect of Dex combined with ropivacaine in treatment of superior brachial plexus and superficial cervical plexus during shoulder arthroscopy

【Objective】To analyze the effect of dexmedetomidine(Dex)combined with ropivacaine in the treatment of superior brachial plexus and superficial cervical plexus during shoulder arthroscopy.【Methods】The clinical data of 70 patients who underwent shoulder arthroscopy with Dex combined with ropivacaine in our hospital from January 2018 to December 2019 were retrospectively analyzed.The clinical data of 31 patients with plexus block were classified as the control group,and the clinical data of 39 patients with brachial plexus and superficial cervical plexus block were classified as the observation group.Heart rate and mean arteries pressure and the degree of postoperative pain of the two groups at different time periods were compared.【Results】There was no statistically significant difference in the heart rate and mean arterial pressure between the two groups before operation(P>0.05);the heart rate of the observation group at 5 minutes during operation,30 minutes during operation and 30 minutes after laryngeal mask removal were higher than that of the control group,the mean arterial pressure was lower in the observation group than in the control group,and the difference was statistically significant(P<0.05);24 hours after operation,the visual analogue scale(VAS)score difference between the two groups was not statistically significant(P>0.05);6 hours and 12 hours after operation,the VAS score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).【Conclusion】Dex combined with ropivacaine in shoulder arthroscopic surgery for superior brachial plexus and superficial cervical plexus nerve block has a good effect,can relieve pain,and has little effect on heart rate.