组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2019, Vol. 15 ›› Issue (5): 349-355.doi: 10.3969/j.issn.1673-0364.2019.05.010

• 论著 • 上一篇    下一篇

右美托咪定联合地佐辛辅助超声引导臂丛神经阻滞麻醉用于上肢骨折手术的疗效观察

孙梅，顾仕贤，王庆宝，曾嵘，毛菇，郭荣春，刘娟，龚晓毅，曹智，陶秀婷   

  1. 南京江北人民医院麻醉科
  • 收稿日期:2019-07-17 修回日期:2019-08-24 出版日期:2019-10-20 发布日期:2019-10-20

Efficacy of Dexmedetomidine Combined with Dezocine Assisted Ultrasound-guided Brachial Plexus Block Anesthesia in the Treatment of Upper Limb Fracture Surgery

SUN Mei,GU Shixian,WANG Qingbao,ZENG Rong,MAO Gu,GUO Rongchun,LIU Juan,GONG Xiaoyi,CAO Zhi,TAO Xiuting   

  1. Department of Anesthesiology, Nanjing Jiangbei People’s Hospital
  • Received:2019-07-17 Revised:2019-08-24 Online:2019-10-20 Published:2019-10-20

摘要： 目的观察右美托咪定联合地佐辛辅助超声引导臂丛神经阻滞麻醉用于上肢骨折手术中的疗效。方法 2017年1月至2019年3月,上肢骨折患者60例随机分为实验组和对照组,每组30例。实验组给予右美托咪定联合地佐辛辅助超声引导臂丛神经阻滞麻醉,对照组给予地佐辛辅助超声引导臂丛神经阻滞麻醉。比较两组患者围术期各时间点的血压、心率、血氧饱和度、Ramsay镇静评分、术后VAS评分和不良反应发生率。结果两组患者围术期各时间点的氧饱和度均较稳定,无统计学差异(P>0.05)。实验组围术期各时间点的血压、心率较稳定,无明显差异(P>0.05)。对照组围术期血压、心率波动较大,差异显著(P0.05)。神经阻滞即刻、麻醉后10 min、手术开始后5 min、手术开始后30 min和手术结束时,实验组Ramsay镇静评分均明显高于对照组(P0.05)。实验组术后VAS评分(1.6±0.5),对照组为(2.0±0.6),差异无统计学意义(P>0.05)。结论右美托咪定联合地佐辛超声引导臂丛神经阻滞麻醉安全有效,具有良好的镇静和镇痛效果。

关键词: 右美托咪定, 地佐辛, 臂丛神经阻滞, 超声, 上肢骨折

Abstract: Objective To observe the efficacy of dexmedetomidine combined with dezocine-assisted ultrasound-guided brachial plexus block anesthesia in the treatment of upper limb fracture surgery. Methods A total of 60 patients with upper limb fracture were enrolled in this study, who were treated from January 2017 to March 2019. All the patients were randomly divided into the experimental group and the control group, with 30 cases in each group. Patients in the experimental group were anesthetized with dexmedetomidine combined with dezocine for ultrasound-guided brachial plexus block, while patients in the control group were anesthetized with dezocine for ultrasound-guided brachial plexus block. Blood pressure, heart rate,oxygen saturation and Ramsay sedation scores were compared between the two groups during the perioperative period. The incidence of intraoperative adverse reactions and the VAS scores after operation were compared between the two groups.Results The oxygen saturation of the two groups were stable at each time point during the perioperative period with no significant difference(P>0.05). The blood pressure and heart rate of the experimental group were stable at each time point during the perioperative period with no significant difference(P >0.05). The blood pressure and heart rate fluctuated significantly in the control group during the perioperative period(P 0.05). Ramsay sedation scores immediately after nerve block,10 minutes after anesthesia, 5 minutes after operation, 30 minutes after operation and at the end of operation in the experimental group were all significantly higher than those in the control group with statistical significance(P0.05), and there were no serious adverse reactions in both groups. Postoperative VAS score showed that the VAS of the experimental group and the control group were(1.6 ±0.5) and(2.0 ±0.6) respectively, with no statistical significance(P >0.05). Conclusion Dexmedetomidine combined with Dizosin assisted ultrasound-guided brachial plexus block anesthe sia is safe and effective with better sedative and analgesic effect in the treatment of upper limb fracture surgery.

Key words: Dexmedetomidine, Dizocine, Brachial plexus block, Ultrasound, Upper limb fracture

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