摘要
目的研究右旋美托咪啶复合臂丛神经阻滞在上肢手术中的应用。方法选择30例单侧上肢手术患者,美国麻醉师协会(ASA)病情分级为Ⅰ～Ⅱ级,将其随机分为右旋美托咪啶组(n=15)和对照组(n=15),患者手术采用臂丛神经阻滞麻醉。右旋美托咪啶组患者匀速静脉泵注右旋美托咪啶负荷剂量1μg/kg,然后按0.1～0.7μg.kg-1.h-1的速率匀速泵注右旋美托咪啶维持至术前30min。对照组用等量生理盐水泵注。监测麻醉前、注药后10min、手术开始时及手术结束时患者平均动脉压(MAP)、心率、脉搏血氧饱和度(SpO2),采用视觉模拟评分法(VAS)判定切皮时、手术结束时及术后30min患者的疼痛程度。结果右旋美托咪啶组患者负荷剂量静脉泵注后MAP、心率比基础值明显降低,较对照组有所降低,所有患者SpO2均正常,无呼吸抑制;对照组患者在不同时间点的VAS疼痛评分明显高于右旋美托咪啶组。结论右旋美托咪啶复合臂丛麻醉能有效提高麻醉质量。
Objective To study the application of dexmedetomidine combined brachial plexus block in upper extremity surgery. Methods 30 patients with American society of anesthesiologists（ASA） grading of Ⅰ～Ⅱwho had accepted unilateral upper extremi ty surgery were randomly divided into dexmedetomidine group（n= 15） and control group（n= 15）. The surgeries were performed under braehial plexus anesthesia. Patients in dexmedetomidine group were intravenously injected with loading dose of dexmedetomi dine 1 μg/kg using micro injection pump at a constant velocity, followed by intravenous injection of dexmedetomidine at rate of 0.1--0.7 μg · kg 1 . h t using micro-injection pump until 30 min before surgery. Patients in control group were injected with equivalent volume of physical saline. Mean arterial pressure（MAP）, heart rate and saturation pulse oxygen（SpO2 ） of patients at the time point of before anesthesia, 10 min after injection,surgery beginning and surgery ending were monitored. Visual analogue scale （VAS） was employed to assay the pain level of patients at the time of skin incision,surgery ending and 30 min after surgery. Results MAP and heart rate of patients in dexmedetomidine group after intravenous injection of loading dose were markedly lower than their base values and those in control group. SpO2 of all patients in dexmedetomidine group was in normal range and no respiratory depression was found. VAS pain scores of patients in control group at different time points were significantly higher than those in dexrnedetomidine group. Conclusion Dexmedetomidine combined brachial plexus block can effectively improve the anesthesia quality.
出处
《重庆医学》
CAS
CSCD
北大核心
2012年第8期746-747,750,共3页
Chongqing medicine
关键词
神经肌肉阻滞
麻醉和镇痛
右旋美托咪啶
neuromuscular blockade
anesthesia and analgesia
dexmedetomidine
