| 右美托咪定辅助臂丛神经阻滞用于断指再植术的临床观察 |
| 投稿时间：2014-06-07 修订日期：2014-06-16 点此下载全文 |
| 引用本文：李晓华,袁力勇.右美托咪定辅助臂丛神经阻滞用于断指再植术的临床观察[J].医学研究杂志,2015,44(1):90-93 |
| DOI：
10.3969/j.issn.1673-548X.2015.01.026 |
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| 基金项目:宁波市优秀中青年卫生技术人才基金资助项目(2007201) |
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| 中文摘要:目的 评价右美托咪定(Dex)辅助臂丛神经阻滞(BPB)用于断指再植术的效果。方法 美国麻醉医师协会(ASA)Ⅰ级、行断指再植术急诊手外伤患者80例,采用数字表法随机分为Dex组(D组)及生理盐水对照组(N组),每组40例。BPB成功后15min,D组患者10min内匀速静脉滴注4μg/ml Dex负荷剂量0.8μg/kg,继以0.4μg/(kg·h)持续静脉滴注至手术结束前30min;N组患者以相同方式静脉滴注等容量生理盐水。记录患者麻醉前(T0)、静脉用药即刻(T1)、手术开始(T2)、手术15min(T3)、手术30min(T4)、手术60min(T5)及手术结束时(T6)平均动脉压(MAP)、心率(HR)、脑电双频指数(BIS)及血糖(Glu)浓度。记录术中低血压、心动过缓、过度镇静、呼吸抑制等不良反应。结果 与T0时间点相比,D组患者T2~T6时间点MAP、HR、BIS均较低(P < 0.05),T2~T6时间点D组患者MAP、HR、BIS均明显低于N组(P < 0.05);与T0时间点相比,D组、N组患者T2~T6时间点血Glu浓度均较低(P < 0.05);T2~T6时间点D组患者血Glu浓度明显低于N组(P < 0.05);两组患者术中不良反应发生率相似。结论 断指再植术时,Dex以负荷剂量0.8μg/kg、继以0.4μg/(kg·h)静脉滴注辅助BPB,镇静效果好,血流动力学稳定,并能有效抑制应激反应。 |
| 中文关键词:右美托咪定 臂丛神经阻滞 断指再植术 |
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| Dexmedetomidine Sedation during Finger Replantation under Brachial Plexus Block |
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| Abstract:Objective To evaluate the safety and effectiveness of dexmedetomidine(Dex) sedation during finger replantation under brachial plexus block. Methods Eighty adult ASA I patients were enrolled in a double-blinded randomized pilot study to receive dexmedetomidine (D group) or normal saline (N group) for sedation during finger replantation. The D group received a loading dose of 4μg/ml Dex 0.8μg/kg followed by an infusion of 0.4μg/(kg·h) until 30min before the operation finished.The N group received same volumes of normal saline.Mean arterial pressure (MAP), heart rate(HR), bispectral index (BIS) and blood glucose concentration at the time of before anesthesia(T0),medication immediately (T1),operation begining (T2),15min after operation (T3), 30min after operation (T4),60min after operation (T5),operation finished (T6) were recorded, respectively.The side effects such as hypotention,bradyarrhythmia,excessive sedation and respiratory depression were also recorded. Results The MAP,HR,BIS in group D at the time of T2,T3,T4, T5, T6 were lower than thos at the time of T0(P < 0.05), respectively. The MAP、HR、BIS in group D at the time of T2,T3,T4, T5, T6 were lower than that in groupN(P < 0.05), respectively. In group D and group N,the blood glucose concentration at the time of T2,T3,T4, T5, T6 were lower than those at the time of T0(P < 0.05). The blood glucose concentration in group D at the time of T2,T3,T4, T5, T6 were lower than those in group N, respectively(P < 0.05). The side effects had no significant difference between two groups. Conclusion Brachial plexus block combined with Dex provides satisfactory level of sedation,hemodynamic stability,and reduces the degree of stress response in patients undergoing finger replantation. |
| keywords:Dexmedetomidine Brachial plexus block Finger replantation |
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