右美托咪定用于辅助臂丛神经阻滞麻醉的效果观察

摘要

Objective To observe the sedative effect of Dex when it was applied in brachial plexus block. Methods 60 patients ( ASA I or II ) were randomly divided into 2 groups:Dex group ( group D ) and control group ( group C ). After brachial plexus block,the patients of group D were injected Dex by a micro pump, the group C were not injected with any medicine. We observed and recorded all patients with Ramsay score,the changes of HR ( heart rate ),MAP ( mean arterial pressure ),RR ( respiratory ),SpO2 ,and the oblivion extent of surgical operation. Results In group D, the sedation score was higher than that in group C ( P < 0. 05 ); HR ( T1 ~ T5 observation points ) and MAP ( T1 ~ T5 points ) were lower than those in group C( P < 0.05 ); RR and SpO2 between the two groups had no significant differences. In group D the operation of the oblivion extent score was also higher than that in group C ( P < 0. 01 ). Conclusion Before the operation,Dex loading dose of 0. 8 μg · Kg-1 was injected by a micro pump,followed by small dose of 0. 2 μg · Kg-1 · H-1, auxiliary for brachial plexus block, has good sedative effect, can effectively inhibit cardiovascular responses, and produce good postoperative amnesia, without respiratory depression, It is safe and can be widely applied.%目的 观察右美托咪定用于辅助臂丛麻醉时的镇静效果.方法 选择60例ASAⅠ～Ⅱ级的上肢手术患者,随机均分为两组.右美托咪定组(D组)和对照组(C组).D组在臂丛阻滞成功后用微量泵泵注右美托咪定,C组不注射任何药物.观察记录两组患者的镇静效果(Ramsay评分)、HR(心率)、MAP(平均动脉压)、RR(呼吸)、SpO2的变化以及术后对手术操作的遗忘程度.结果 D组患者镇静评分显著高于C组(P<0.05);MAP(T1～T5观察点)和HR(T1～T5观察点)均低于C组(P<0.05);RR和SpO2两组间比较没有显著差异(P>0.05);对手术操作的遗忘程度D组显著高于C组(P<0.01).结论 右美托咪定辅助臂丛神经阻滞麻醉时,在手术开始前缓慢(≥10 min)静脉泵注负荷剂量0.8 μg·kg-1,继以小剂量0.2 μg·kg-1·h-1维持,具有良好的镇静作用,可有效地抑制心血管反应,并可产生良好的术后遗忘作用,且无呼吸抑制,其安全性高,具有一定的推广价值.