目的 探讨右美托咪定联合臂丛神经阻滞麻醉在上肢骨折手术患者中的应用效果.方法 将86例上肢骨折手术患者随机分为基础组(43例,臂丛神经阻滞麻醉)和联合组(43例,右美托咪定联合臂丛神经阻滞麻醉),比较两组MAP、HR、麻醉效果及麻醉不良反应发生情况.结果 麻醉前、麻醉1min,两组的MAP、HR比较无统计学差异(P＞0.05);麻醉30 min、术毕,联合组MAP高于基础组,HR低于基础组(P＜0.05).联合组感觉阻滞起效时间、运动阻滞起效时间短于基础组,感觉阻滞维持时间、运动阻滞维持时间长于基础组(P＜0.05).联合组低血压发生率为2.33％,低于基础组的18.60％(P＜0.05).结论 右美托咪定联合臂丛神经阻滞麻醉可明显维持上肢骨折手术患者血流动力学稳定,提高麻醉效果,降低患者低血压发生率.
Objective To explore the application effect of dexmedetomidine combined with brachial plexus nerve block anesthesia in patients with upper limb fracture surgery.Methods 86 patients undergoing upper limb fracture surgery were randomly divided into basic group(43 cases,brachial plexus nerve block anesthesia)and combined group(43 cases,dexmedetomidine combined with brachial plexus nerve block anesthesia).The MAP,HR,anesthetic effect and anesthetic adverse reactions of the two groups were compared.Results Before anesthesia and 1 min after anesthesia,no statistical difference was found in the MAP and HR between the two groups(P＞0.05).30 min after anesthesia and at the end of operation,the MAP of the combined group was higher than that of the basic group,and the HR was lower than that of the basic group(P＜0.05).The onset time of sensory block and motor block in the combined group were shorter than those in the basic group,and the maintenance time of sensory block and motor block were longer than those in the basic group(P＜0.05).The incidence of hypotension in the combined group was 2.33％,lower than 18.60％in the basic group(P＜0.05).Conclusions Dexmedetomidine combined with brachial plexus nerve block anesthesia can significantly maintain hemodynamic stability,improve the anesthetic effect and reduce the incidence of hypotension in patients undergoing upper limb fracture surgery.
李小磊;邵丹
郑州市骨科医院麻醉科,河南郑州 450052
临床医学
上肢骨折手术;右美托咪定;臂丛神经阻滞麻醉;麻醉效果
Upper limb fracture surgery;Dexmedetomidine;Brachial plexus nerve block anesthesia;Anesthetic effect
《临床医学工程》 2024 (005)
609-610 / 2
10.3969/j.issn.1674-4659.2024.05.0609
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