河北医科大学学报

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小剂量右旋美托咪定对罗哌卡因蛛网膜下腔阻滞效应及血液动力学的影响

  

  1. 河北省石家庄市第一医院麻醉科,河北 石家庄 050011
  • 出版日期:2016-01-25 发布日期:2016-04-27

Effect and hemodynamics of a low dose dexmedetomidine on ropivacaine subarachnoid block

  1. Department of Anesthesia,the  First Hospital of Shijiazhuang City,Shijiazhuang 050011,China
  • Online:2016-01-25 Published:2016-04-27

摘要: 目的 探究小剂量右旋美托咪定对罗哌卡因蛛网膜下腔阻滞效应及血液动力学的影响。方法 选择
下肢骨科手术治疗患者 52 例,均以蛛网膜下腔阻滞方式进行麻醉。随机分成观察组( n =26 )与对照组( n =26 ),观
察组麻醉药物为 3 μ g 右旋美托咪定 +5g / L 罗哌卡因,对照组麻醉药物为 5g / L 罗哌卡因。观察 2 组麻醉效果、不
良反应及血液动力学指标变化。结果 观察组感觉阻滞起效时间、运动阻滞起效时间明显短于对照组,感觉阻滞时
间、运动阻滞时间明显长于对照组, Bromage 评分和舒适度评分显著优于对照组(
P <0.01 )。 2 组给药 0 、 10 、 30 、
60 、 90min 时血流动力学指标差异无统计学意义( P >0.05 )。 2 组不良反应发生率差异无统计学意义( P >0.05 )。
结论 小剂量右旋美托咪定对罗哌卡因蛛网膜下腔阻滞效果更佳,不良反应更少,且对血液动力指标无显著影响,
具有较高的临床应用价值。

关键词: 麻醉, 脊椎, 右美托咪啶, 罗哌卡因

Abstract: ] Objective Tostudytheeffectandhemodynamicsofalowdosedexmedetomidine
onropivacainesubarachnoidblock.Methods Fifty-twopatientswithlowerextremitysurgery
weretreated by subarachnoid block anesthesia.The patients wererandomly dividedinto
observationgroup ( n =26 ) andcontrolgroup (
n =26 ) .Thepatientsinobservationgroupwere
usedwithnarcoticdrugs3 μ gdextralmedetomidine+5g / Lropivacaine , whilethoseofcontrol
groupweretreatedwithropivacaine5g
/ Lalone.Theeffectofanesthesia , adversereactionsand
hemodynamicparameterswereobservedintwogroups.Results Theonsettimeofsensoryblock
andtheonsettimeofmotorblockinobservationgroupweresignificantlyshorterthanthoseof
controlgroup , but , thetimeofsensoryblockandexercisetimeinobservationgroup were
significantlylongerthanthoseincontrolgroup ( P <0.01 ) .TheBromagescoreandcomfortscore
inobservationgroupweresignificantlyhigherthanthoseincontrolgroup ( P >0.05 ) .Twogroups
showednosignificantchangesinhemodynamicparameterssuchas MAP , SV , andCOafter
beingtreated0 , 10 , 30 , 60 , 90minutes ( P >0.05 ) .Therewerenosignificantdifferenceinthe
incidence of adverse reactions between two groups ( P > 0.05 ) .Conclusion Low dose
dexmedetomidinemidazolamhasgoodeffectinropivacainesubarachnoidblock.Thedrugshows
highclinicalapplicationvaluelessduetoadversereactionsandnosignificanteffectforblood
dynamicindexes.