| 施克俭,夏芳芳,陈鸿飞,金周晟,刘乐.右美托咪定对臂丛神经阻滞罗哌卡因血药浓度和镇痛效果的影响[J].浙江中西医结合杂志,2020,30(6): |
| 右美托咪定对臂丛神经阻滞罗哌卡因血药浓度和镇痛效果的影响 |
| Effects of dexmedetomidine on ropivacaine blood concentration and analgesic effect of brachial plexus block |
| 投稿时间：2020-01-03 修订日期：2020-03-19 |
| DOI： |
| 中文关键词: 超声引导 罗哌卡因 右美托咪定 区域麻醉 血药浓度 |
| 英文关键词:Ultrasound Guidance Ropivacaine Dexmedetomidine Regional Anesthesia Blood Concentration |
| 基金项目:国家自然科学基金资助项目(81900231)；温州市科技局科研基金资助项目(Y20170645) |
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| 中文摘要: |
| 目的：本研究将右美托咪定添加到罗哌卡因进行腋路臂丛神经阻滞，检测罗哌卡因血药浓度，研究阻滞效果与血药浓度的关系。
方法：选择前臂手术的患者40例，随机分为右美托咪定+罗哌卡因组和罗哌卡因组，每组20例。右美托咪定+罗哌卡因组患者75mg罗哌卡因与1μg/kg右美混合稀释成20ml行腋路臂丛神经阻滞，罗哌卡因组患者75mg罗哌卡因稀释成20ml行腋路臂丛神经阻滞。阻滞后不同时间点采集患者血样检测罗哌卡因血药浓度，记录不同时间点患者静息痛和运动痛疼痛评分（NRS评分），记录术后补充镇痛例数和不良反应发生情况。
结果：臂丛阻滞后10min，15min，30min，60min和120min 右美托咪定+罗哌卡因组患者罗哌卡因血药浓度均低于罗哌卡因组（P<0.05）。臂丛阻滞后12h和24h右美托咪定+罗哌卡因组患者的静息痛和运动痛NRS评分均低于罗哌卡因组（P<0.05）。术后补充镇痛例数罗哌卡因组患者显著多余右美托咪定+罗哌卡因组（P<0.05）。两组患者恶心呕吐、心动过缓、过度镇静等不良反应均未发生。
结论：右美托咪定添加到罗哌卡因进行腋路臂丛神经阻滞，降低罗哌卡因血药浓度，延长臂丛阻滞时间。 |
| 英文摘要: |
| Objective: In this study, dexmedetomidine was added to ropivacaine for brachial plexus block, to detect the ropivacaine blood concentration and discuss the relationship between block effect and blood concentration.
Methods: Forty patients with forearm surgery were randomly divided into Dexmedetomidine + Ropivacaine group and Ropivacaine group, twenty cases in each group. In the Dexmedetomidine + Ropivacaine group, 75 mg of ropivacaine was diluted with 1 μg/kg of dexamethasone into 20 ml for brachial plexus block. In the Ropivacaine group, only 75 mg of ropivacaine was diluted into 20 ml for brachial plexus block. Blood samples were taken at different time points to detect the blood concentration of ropivacaine. The numerical rating scale (NRS scores) at rest and movement were recorded at different time points. The number of postoperative analgesia and adverse reactions were recorded.
Results: The blood concentration of ropivacaine in the Dexmedetomidine + Ropivacaine group was lower than that in the Ropivacaine group (P<0.05) at 10 min, 15 min, 30 min, 60 min and 120 min. The NRS scores at rest and movement in the Dexmedetomidine + Ropivacaine group at 12 hours and 24 hours were lower than those in the Ropivacaine group (P<0.05). The cases of postoperative analgesia was significantly less in the Dexmedetomidine + Ropivacaine group (P<0.05). Adverse reactions such as nausea and vomiting, bradycardia, and excessive sedation did not occur in both two groups.
Conclusion: Dexmedetomidine added to ropivacaine for brachial plexus block reduced the blood concentration of ropivacaine and prolonged the block time. |
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