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在上肢骨科手术患者静脉区域麻醉中,比较添加到利多卡因中的两种不同剂量右美托咪定的效果。

Comparison of Two Different Doses of Dexmedetomidine Added to Lignocaine in Patients Posted for Upper Limb Orthopedic Surgery Under Intravenous Regional Anaesthesia.

作者信息

Mansour Mostafa Saieed, Kom Shebin El, Ahmed Mohamed, Rady Ayman, Sadik Sadik

机构信息

Anesthesiology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt.

出版信息

Rom J Anaesth Intensive Care. 2022 Dec 29;28(2):63-70. doi: 10.2478/rjaic-2021-0011. eCollection 2021 Dec.

Abstract

BACKGROUND

Intravenous regional anaesthesia (IVRA) is a dependable and safe technique specific anatomical knowledge is not required. The present research aimed to evaluate the effects of dexmedetomidine in combination with lidocaine and to compare the onset of motor and sensory block and evaluate the postoperative analgesia, as well as the side effects.

METHODS

A prospective randomized controlled double-blinded study was conducted on 90 patients assigned randomly into three equal groups,. Group (I) received only lidocaine 2% 3mg/kg for Bier block. Group (II) received lidocaine 2% 3mg/kg with plus dexmedetomidine 0.25 μg/kg for Bier block. Group (III) received lidocaine 2% 3mg/kg plus dexmedetomidine 0.5 μg/kg for Bier block.

RESULTS

Postoperative VAS was lower in a statistically significant way in the group III patients than those in groups I and II and this followed a reduction in the analgesic requirement in group III.

CONCLUSIONS

The combination of dexmedetomidine 0.5 μg/kg with lidocaine 2% (3mg/kg) when applying intravenous regional anaesthesia (IVRA) allowed improved postoperative analgesia. Furthermore, the combination reduced onset time, extended recovery time for sensory/motor blocks and did not affect the incidence of intra-operative and postoperative complications.

摘要

背景

静脉区域麻醉(IVRA)是一种可靠且安全的技术,无需特定的解剖学知识。本研究旨在评估右美托咪定与利多卡因联合使用的效果,比较运动和感觉阻滞的起效时间,评估术后镇痛情况以及副作用。

方法

对90例患者进行前瞻性随机对照双盲研究,将患者随机分为三组,每组人数相等。第一组仅接受2%利多卡因3mg/kg用于静脉 Bier 阻滞;第二组接受2%利多卡因3mg/kg加右美托咪定0.25μg/kg用于静脉 Bier 阻滞;第三组接受2%利多卡因3mg/kg加右美托咪定0.5μg/kg用于静脉 Bier 阻滞。

结果

第三组患者术后视觉模拟评分(VAS)显著低于第一组和第二组患者,且第三组的镇痛需求减少。

结论

在进行静脉区域麻醉(IVRA)时,右美托咪定0.5μg/kg与2%利多卡因(3mg/kg)联合使用可改善术后镇痛效果。此外,该联合用药缩短了起效时间,延长了感觉/运动阻滞的恢复时间,且不影响术中及术后并发症的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0937/9949030/e2b1c9e80faa/rjaic-28-063-g001.jpg

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