右美托咪定对腋路臂丛神经阻滞联合肩胛上神经阻滞患者术后反弹性疼痛的影响OA
Effect of dexmedetomidine on postoperative rebound pain in patients with axillary brachial plexus block combined with suprascapular nerve block
目的 探究右美托咪定对腋路臂丛神经阻滞联合肩胛上神经阻滞患者术后反弹性疼痛的影响.方法 收录2024年9月—2025年10月期间我院接受肩关节镜手术治疗的患者,合计收录样本量为150例,将患者随机分为两组(n=150):常规腋路臂丛神经阻滞联合肩胛上神经阻滞组(N组,n=75)、复合右美托咪定的腋路臂丛神经阻滞联合肩胛上神经阻滞组(D组,n=75);评价组间反弹性疼痛、术后恢复情况及应急指标差异.结果 术后2 h、6 h、12 h、24 h疼痛视觉模拟量表(VAS)评分D组较N组更低(P＜0.05).反弹性疼痛发生率D组(5.33%)较N组(20.00%)更低,首次发作时间D组较N组更迟,持续时间D组较N组更短(P＜0.05).术后补救镇痛次数、阿片类药物用量、非甾体药物使用率D组较N组更低(P＜0.05).术后首次下床时间和住院时长D组较N组更短,满意度评分D组较N组更高(P＜0.05).不良反应发生率D组与N组比较,差异无统计学意义(P＞0.05).术前组间应激反应指标未见明显差异,术后24 h两组均有不同程度的指标变化,但相较N组而言,D组心率、平均动脉压、收缩压、舒张压变化幅度更小(P＜0.05).结论 右美托咪定用于腋路臂丛神经阻滞联合肩胛上神经阻滞患者,在降低术后疼痛程度及反弹性疼痛发生率、促进术后康复进程有显著价值,对术后不良反应发生率及应激反应的影响较小.
Objective To explore the effect of dexmedetomidine on postoperative rebound pain in patients with axillary brachial plexus block combined with suprascapular nerve block.Methods From September 2024 to October 2025,150 patients who underwent arthroscopic surgery in our hospital were randomly divided into two groups(n=150):conventional axillary brachial plexus block combined with suprascapular nerve block group(N group,n=75)and axillary brachial plexus block combined with dexmedetomidine group(D group,n=75).The differences of rebound pain,postoperative recovery and emergency indicators between groups were evaluated.Results The pain scores at 2 hours,6 hours,12 hours and 24 hours after operation in group D were lower than those in group N(P＜0.05).The incidence of rebound pain in group D(5.33%)was lower than that in group N(20.00%),the first attack time in group D was later and the duration in group D was shorter than those in group N(P＜0.05).The times of postoperative salvage analgesia,the dosage of opioids and the utilization rate of non-steroidal drugs in group D were lower than those in group N(P＜0.05).The time of getting out of bed for the first time and the length of hospitalization in group D were shorter than those in group N,and the satisfaction score in group D was higher than that in group N(P＜0.05).There was no significant difference in the incidence of adverse reactions between group D and group N(P＞0.05).There was no significant difference in stress response indexes between groups before operation,and the indexes of both groups changed in different degrees 24 hours after operation,but compared with group N,the changes of heart rate,mean arterial pressure,systolic pressure and diastolic pressure in group D were smaller(P＜0.05).Conclusions Dexmedetomidine used in axillary brachial plexus block combined with suprascapular nerve block has significant value in reducing postoperative pain and incidence of rebound pain,promoting postoperative rehabilitation process,and has little effect on postoperative adverse reactions and stress response.
梁苑;李刚;彭通
首都医科大学附属北京安贞医院南充医院,南充市中心医院麻醉科(四川 南充 637000)首都医科大学附属北京安贞医院南充医院,南充市中心医院麻醉科(四川 南充 637000)首都医科大学附属北京安贞医院南充医院,南充市中心医院麻醉科(四川 南充 637000)
腋路臂丛神经阻滞肩胛上神经阻滞右美托咪定疼痛程度反弹性疼痛康复进程
axillary brachial plexus blocksuprascapular nerve blockdexmedetomidinepain levelrebound painrehabilitation process
《广州医药》 2026 (7)
829-833,842,6
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