Effects of dexmedetomidine on onset and duration of supraclavicular brachial plexus block induced by levobupivacaine
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摘要: 目的 评价右美托咪啶对左布比卡因超声引导下行锁骨上臂丛神经阻滞时效及术后疼痛的影响。 方法 选取80例ASA 分级Ⅰ~Ⅱ级拟择期行上肢手术的患者，随机分成两组：对照组（简称C组），局麻药为含1 ml生理盐水的0.5%左布比卡因30 ml；右美托咪啶组（简称D组），局麻药为含100 μg右美托咪啶（1 ml）的0.5%左布比卡因30 ml。麻醉方法均为超声引导下行锁骨上臂丛神经阻滞。观察指标为：麻醉后上肢感觉神经阻滞、运动神经阻滞的起效时间、持续时间；术后第一次应用镇痛药的时间；麻醉后2 h内的血流动力学指标（平均动脉压和心率）。 结果 锁骨上臂丛神经阻滞后，两组患者在感觉神经阻滞完全起效的时间上无统计学差异；但与C组相比，D组患者的运动神经阻滞完全起效时间明显缩短（P<0.01），感觉和运动神经阻滞的持续时间均显著延长（P<0.001），术后第一次需求镇痛药的时间也明显长于C组（P<0.001）。同样，D组患者的平均动脉压和心率均明显低于C组（P<0.02）。 结论 右美托咪啶能够明显延长左布比卡因用于锁骨上臂丛神经阻滞的时效和术后镇痛的时间。Abstract: Objective To evaluate effects of dexmedetomidine on onset, duration of supraclavicular brachial plexus block induced by levobupivacaine and postoperative analgesia with ultrasound guide. Methods Eighty patients undergoing elective surgeries of distal arm and forearm with class Ⅰ~Ⅱ ASA were enrolled, and the patients were randomly divided into two groups, one was control group (group C) patients with supraclavicular brachial plexus block by 30 ml of 5% levobupivacaine contained 1 ml normal saline, the other was dexmedetomidine group patients (group D) with supraclavicular brachial plexus block by 30 ml of 5% levobupivacaine contained 100 μg dexmedetomidine. The supraclavicular brachial plexus block was guided with ultrasound. Observation indicators include: sensory and motor onset blocks, duration of sensory and motor blocks, time to first rescue analgesia and hemodynamic parameters. Results The differences of sensory block onset between group C and D were not significant. Compared to group C, motor block onset of group D was significantly shorter (P<0.01), sensory block duration and motor block duration were longer (P<0.001), time to first rescue analgesia after the surgeries was longer (P<0.001). Mean arterial pressure and mean heart rate of group D were significantly lower than those of group C, respectively (P<0.02). Conclusions Dexmedetomidine can significantly prolong the duration of block and postoperative analgesia of supraclavicular brachial plexus block induced by levobupivacaine.
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Key words:
- dexmedetomidine /
- levobupivacaine /
- supraclavicular brachial block
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