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右美托咪定作为上肢手术静脉区域麻醉的辅助用药

Dexmedetomidine as an Adjuvant for Intravenous Regional Anesthesia in Upper Limb Surgeries.

作者信息

Subramanya Vani, Kapinigowda Shashikala Thuraganur, Math Aruna Teggina, Chennaiah Vijayalakshmi Beladakere

机构信息

Department of Anaesthesiology, Rajarajeswari Medical College and Research Institute and Hospital, Mysore, Karnataka, India.

Department of Anaesthesiology, Mysore Medical College and Research Institute, Mysore, Karnataka, India.

出版信息

Anesth Essays Res. 2017 Jul-Sep;11(3):661-664. doi: 10.4103/0259-1162.206851.

Abstract

BACKGROUND

Intravenous regional anaesthesia is a simple, safe and effective technique with good success rate for upper limb surgeries. The duration of postoperative analgesia is an important limitation of this technique. Various adjuvants have been used to overcome this drawback. In this study we evaluate the effect of dexmedetomidine 0.5 μgkg as an adjuvant for lignocaine intravenous regional anaesthesia.

METHODS

Sixty patients scheduled to undergo upper limb surgery were randomised to receive intravenous regional anaesthesia with lignocaine alone (Group L) or lignocaine with dexmedetomidine 0.5 μgkg (Group LD). The quality of anaesthesia, onset of sensory and motor blocks and duration of postoperative analgesia were noted.

RESULTS

The onset of sensory and motor block was significantly rapid in group LD compared to group L (Group LD v/s Group L, sensory block: 2.5min ± 0.5v/s6.34min ± 0.7; motor block: 8.5min ± 1.05v/s14.78min ± 0.6; < 0.001). The quality of anaesthesia was superior in group LD compared to group L and the duration of postoperative analgesia was also longer in group LD.

CONCLUSION

Dexmedetomidine 0.5 μkg as an adjuvant to lignocaine for IVRA shortens the onset of sensory and motor blocks, improves the quality of anaesthesia and provides longer postoperative analgesia.

摘要

背景

静脉区域麻醉是一种简单、安全且有效的技术,在上肢手术中成功率较高。术后镇痛时间是该技术的一个重要局限性。已使用多种佐剂来克服这一缺点。在本研究中,我们评估了0.5μg/kg右美托咪定作为利多卡因静脉区域麻醉佐剂的效果。

方法

60例计划行上肢手术的患者被随机分为两组,分别接受单纯利多卡因静脉区域麻醉(L组)或利多卡因加0.5μg/kg右美托咪定静脉区域麻醉(LD组)。记录麻醉质量、感觉和运动阻滞的起效时间以及术后镇痛时间。

结果

与L组相比,LD组感觉和运动阻滞的起效明显更快(LD组与L组比较,感觉阻滞:2.5分钟±0.5/6.34分钟±0.7;运动阻滞:8.5分钟±1.05/14.78分钟±0.6;P<0.001)。LD组的麻醉质量优于L组,且LD组的术后镇痛时间也更长。

结论

0.5μg/kg右美托咪定作为利多卡因静脉区域麻醉的佐剂可缩短感觉和运动阻滞的起效时间,提高麻醉质量,并提供更长时间的术后镇痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d7c/5594786/cc3933f227ab/AER-11-661-g003.jpg

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