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右美托咪定作为罗哌卡因在锁骨上臂丛神经阻滞中的辅助用药

Dexmedetomidine as an adjuvant to ropivacaine in supraclavicular brachial plexus block.

作者信息

Kathuria Suneet, Gupta Shikha, Dhawan Ira

机构信息

Department of Anesthesia. Dayanand Medical College and Hospital, Ludhiana, Punjab, India.

出版信息

Saudi J Anaesth. 2015 Apr-Jun;9(2):148-54. doi: 10.4103/1658-354X.152841.

Abstract

CONTEXT

Dexmedetomidine as an adjuvant to local anesthetics in peripheral nerve blocks has been used in only a few studies.

AIMS

We aimed at assessing the effect of dexmedetomidine as an adjuvant to ropivacaine in supraclavicular brachial plexus block.

SETTINGS AND DESIGN

Random, controlled, and triple blind.

MATERIALS AND METHODS

Sixty American Society of Anesthesiologist grade I and II patients of either sex scheduled for elective upper limb surgery under supraclavicular brachial plexus block were divided into three equal groups in a prospective randomized double-blind controlled manner. For block patients in Group C received 0.5% ropivacaine (30cc), 0.5% ropivacaine with 50 μg dexmedetomidine (30cc) in Group D and 0.5% ropivacaine (30cc) in Group D-IV along with intravenous infusion of 50 μg dexmedetomidine in normal saline.

STATISTICAL ANALYSIS USED

IBM-SPSS software version 17, Chi-square test, Mann-Whitney U-test.

RESULTS

Demographic profile and surgical characteristics were similar in all the three groups. Sensory block and motor block onset was earlier in group D than in group D-IV and group C. The sensory block and motor block duration was also prolonged in group D when compared with group D-IV and group C. The duration of analgesia was significantly longer in group D and D-IV when compared to group C.

CONCLUSIONS

Dexmedetomidine as an adjuvant to 0.5%ropivacaine in ultrasound guided brachial plexus block shortens the sensory as well as motor block onset time, prolongs sensory and motor block duration and also increases the duration of analgesia. The action of dexmedetomidine most probably is local rather than centrally mediated.

摘要

背景

右美托咪定作为外周神经阻滞局部麻醉药的辅助用药仅在少数研究中使用过。

目的

我们旨在评估右美托咪定作为罗哌卡因辅助用药在锁骨上臂丛神经阻滞中的效果。

设置与设计

随机、对照、三盲。

材料与方法

将60例计划在锁骨上臂丛神经阻滞下行择期上肢手术的美国麻醉医师协会I级和II级患者,以前瞻性随机双盲对照方式分为三组。C组患者接受0.5%罗哌卡因(30毫升),D组接受0.5%罗哌卡因加50微克右美托咪定(30毫升),D-IV组接受0.5%罗哌卡因(30毫升),同时静脉输注含50微克右美托咪定的生理盐水。

统计分析方法

IBM-SPSS软件版本17,卡方检验,曼-惠特尼U检验。

结果

三组患者的人口统计学特征和手术特点相似。D组感觉阻滞和运动阻滞起效时间早于D-IV组和C组。与D-IV组和C组相比,D组感觉阻滞和运动阻滞持续时间也延长。与C组相比,D组和D-IV组镇痛持续时间显著更长。

结论

在超声引导下臂丛神经阻滞中,右美托咪定作为0.5%罗哌卡因的辅助用药可缩短感觉和运动阻滞起效时间,延长感觉和运动阻滞持续时间,并增加镇痛持续时间。右美托咪定的作用很可能是局部性的而非中枢介导的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59c4/4374219/0687f8c505e8/SJA-9-148-g003.jpg

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