右美托咪定复合罗哌卡因在臂丛神经阻滞临床应用.docVIP

右美托咪定复合罗哌卡因在臂丛神经阻滞临床应用 　　摘要：目的 探讨右美托咪定复合罗哌卡因在臂丛神经阻滞的临床应用。方法 选取2013年6月～2014年3月的上肢外伤患者56例，将56例患者随机分成两组，即R组（单独使用罗哌卡因药物麻醉组）和D组（复合使用右美托咪定和罗哌卡因药物麻醉组）。R组的28例患者麻醉时直接注射0.5%的罗哌卡因25 ml。D组的28例患者麻醉时采用复合型药物进行麻醉，患者注射0.5%的罗哌卡因25 ml和12.5 μg的右美托咪定溶液。分别在麻醉前（T0），手术开始（T1），手术开始后的30 min（T2）和手术结束（T3）后记录患者的心率（HR），平均动脉血压（MAP），氧饱和度（SpO2）。并且记录观察两组患者感觉和运动的阻滞效果和麻醉效果。结果 R组患者的心率在T1～T3时明显高于D组，D组的MAP在患者麻醉过后与R组比较有明显的降低。D组的感觉阻滞起效时间和运动阻滞起效时间均短于R组的时间，并且感觉和运动阻滞持续时间均长于R组，具有统计学意义（P0.05）。两组患者的不良反应和术后的并发症均不明显。结论 右美托咪定复合罗哌卡因在臂丛神经阻滞的临床效果好，不良反应和术后并发症少。 　　关键词：右美托咪定；罗哌卡因；臂丛神经阻滞 　　Clinical Application of Dexmedetomidine Combined with Ropivacaine on Brachial Plexus Block 　　WANG Ming-hong 　　（Department of Anesthesiology，Ningde Hospital，Ningde 352100，Fujian，China） 　　Abstract：Objective To explore clinical application of dexmedetomidine combined with ropivacaine on brachial plexus block.Methods From June 2013toMarch 2014，56 patients were selection on upper limb trauma，56 patients were randomly divided into two groups，group R（single use ropivacaine）and group D（dexmedetomidine combined with ropivacaine）.group R of 28 patients with anesthesia were treated with 25 ml of 0.5%of ropivacaine.Group D of 28 patients were treated with 25 ml of 0.5%of ropivacaine and 12.5μg dexmedetomidine.Before anesthesia（T0），start（T1），30 min（T2）and after the beginning of the operation after the end of surgery（T3）of the patients heart rate（HR），mean arterial blood pressure（MAP），oxygen saturation（SpO2）.Were investigated.Motor and sensory block onset times，block durations，and duration of analgesia were recorded.Results The group R of heart rate was significantly higher in T1-T3 than group D.The group D of MAP was significantly lower than group R after anesthesia.Motor and sensory block on set times in group D were significantly shorter than that in group R（P0.05），duration and motor block and sensory blockade perfect time were longer than the R group，there was statistically significantdifference（P0.05）.The adverse effects and postoperative c