Lin Yu-Nan, Li Qiang, Yang Rui-Min, Mao Zhong-Xuan, Liu Jing-Chen
Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Acta Anaesthesiol Taiwan. 2013 Jun;51(2):63-6. doi: 10.1016/j.aat.2013.06.001. Epub 2013 Jul 16.
To investigate the sensory block onset time, duration time, and side effects of adding dexmedetomidine to ropivacaine for cervical plexus block.
Forty American Society of Anesthesiologists (ASA) Class I or II adult patients who were scheduled to undergo thyroid surgery were randomly allocated to the following groups to receive cervical plexus block: 30 mL of 0.375% ropivacaine combined with 1 μg kg(-1) of dexmedetomidine; 30 mL of 0.375% ropivacaine combined with saline (control). The sensory block onset time, duration of analgesia, mean arterial pressure (MAP), heart rate (HR), and the incidences of side effects, such as hypotension, bradycardia, and hypoxemia were recorded.
The addition of dexmedetomidine to ropivacaine (Group D) shortened the sensory block onset time compared with the ropivacaine group (Group C) (95% confidence interval [CI] 4.18-5.26; p < 0.05). The duration of analgesia of cervical plexus block in Group D was significantly longer than that in Group C (95% CI 295.96-311.12; p < 0.05). The Ramsay sedation score at 5, 10, 20, 40, 60, 90, and 120 minutes after local anesthetic administration in Group D was significantly higher than that in Group C (p < 0.05). MAP level and HR level in Group D were significantly lower than that in Group C (p < 0.05).
The addition of 1 μg kg(-1) dexmedetomidine to ropivacaine for cervical plexus block could shorten the sensory block onset time and extend the duration of analgesia, and increased the quality of analgesia, with the patients being sedated and arousable.
探讨在罗哌卡因中添加右美托咪定用于颈丛阻滞的感觉阻滞起效时间、持续时间及副作用。
将40例拟行甲状腺手术的美国麻醉医师协会(ASA)Ⅰ或Ⅱ级成年患者随机分为以下几组接受颈丛阻滞:30 mL 0.375%罗哌卡因联合1 μg/kg右美托咪定;30 mL 0.375%罗哌卡因联合生理盐水(对照组)。记录感觉阻滞起效时间、镇痛持续时间、平均动脉压(MAP)、心率(HR)以及低血压、心动过缓和低氧血症等副作用的发生率。
与罗哌卡因组(C组)相比,罗哌卡因中添加右美托咪定(D组)缩短了感觉阻滞起效时间(95%置信区间[CI] 4.18 - 5.26;p < 0.05)。D组颈丛阻滞的镇痛持续时间明显长于C组(95% CI 295.96 - 311.12;p < 0.05)。局部麻醉给药后5、10、20、40、60、90和120分钟时,D组的Ramsay镇静评分明显高于C组(p < 0.05)。D组的MAP水平和HR水平明显低于C组(p < 0.05)。
在罗哌卡因中添加1 μg/kg右美托咪定用于颈丛阻滞可缩短感觉阻滞起效时间,延长镇痛持续时间,并提高镇痛质量,患者可镇静且可唤醒。