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右美托咪定作为辅助药物与0.75%罗哌卡因用于神经刺激器引导下肌间沟臂丛神经阻滞的效果:一项前瞻性、随机双盲研究

Effect of Dexmedetomidine as an Adjuvant to 0.75% Ropivacaine in Interscalene Brachial Plexus Block Using Nerve Stimulator: A Prospective, Randomized Double-blind Study.

作者信息

Rashmi H D, Komala H K

机构信息

Department of Anaesthesiology, Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India.

出版信息

Anesth Essays Res. 2017 Jan-Mar;11(1):134-139. doi: 10.4103/0259-1162.181431.

Abstract

BACKGROUND

Ropivacaine, a newer local anesthetic (LA), has been increasingly used nowadays in different concentrations for peripheral nerve blocks. It has lesser cardiac toxicity and higher safety margin when compared to bupivacaine. Dexmedetomidine, a novel α agonist, is widely used as adjuvant to LA in peripheral nerve blocks to decrease the time of onset and increase the duration of the block. In this study, we evaluated the effect of dexmedetomidine as an adjuvant with 0.75% ropivacaine for interscalene brachial plexus block using nerve stimulator.

AIM

This study aims to know the effect of using dexmedetomidine as an adjuvant to 0.75% ropivacaine in interscalene brachial plexuses block using nerve stimulator.

SETTINGS AND DESIGNS

Sixty patients scheduled for elective orthopedic surgery of the upper limb under interscalene block were considered in this prospective randomized controlled double-blind study. The study population was randomly divided into two groups with thirty patients in each group by using computerized randomization.

MATERIALS AND METHODS

Group R received 30 ml of 0.75% ropivacaine with 0.5 ml normal saline and Group RD received 30 ml of 0.75% ropivacaine with 50 μg of dexmedetomidine. The onset of sensory and motor blocks, duration of sensory and motor block, and patient satisfaction score were observed.

RESULTS

Both the groups were comparable in demographic characteristics. The onset of the sensory and motor block is earlier and statistically significant in Group RD ( < 0.05) when compared to Group R. The duration of sensory and motor blockade were significantly prolonged in Group RD ( < 0.0001).

CONCLUSION

Addition of dexmedetomidine to 0.75% ropivacaine in interscalene brachial plexus block significantly shortened the time of onset of the block and prolongs the duration sensory and motor blockade.

摘要

背景

罗哌卡因是一种新型局部麻醉药(LA),如今越来越多地以不同浓度用于外周神经阻滞。与布比卡因相比,它具有较低的心脏毒性和更高的安全边际。右美托咪定是一种新型α激动剂,在外周神经阻滞中广泛用作局部麻醉药的佐剂,以缩短起效时间并延长阻滞持续时间。在本研究中,我们使用神经刺激器评估了右美托咪定作为佐剂与0.75%罗哌卡因用于肌间沟臂丛神经阻滞的效果。

目的

本研究旨在了解使用神经刺激器时,右美托咪定作为0.75%罗哌卡因在肌间沟臂丛神经阻滞中的佐剂的效果。

设置与设计

本前瞻性随机对照双盲研究纳入了60例计划在肌间沟阻滞下进行上肢择期骨科手术的患者。通过计算机随机化将研究人群随机分为两组,每组30例患者。

材料与方法

R组接受30 ml 0.75%罗哌卡因加0.5 ml生理盐水,RD组接受30 ml 0.75%罗哌卡因加50 μg右美托咪定。观察感觉和运动阻滞的起效时间、感觉和运动阻滞的持续时间以及患者满意度评分。

结果

两组在人口统计学特征方面具有可比性。与R组相比,RD组感觉和运动阻滞的起效更早且具有统计学意义(<0.05)。RD组感觉和运动阻滞的持续时间显著延长(<0.0001)。

结论

在肌间沟臂丛神经阻滞中,将右美托咪定添加到0.75%罗哌卡因中可显著缩短阻滞的起效时间,并延长感觉和运动阻滞的持续时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16eb/5341687/8f996a6067c1/AER-11-134-g003.jpg

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