不同剂量右美托咪定复合罗哌卡因臂丛阻滞用于小儿多指手术的效果比较

发布时间：2018-11-13 16:45

【摘要】：目的观察不同剂量右美托咪定(Dex)复合罗哌卡因腋路臂丛阻滞用于小儿多指手术的比较的效果及安全性。方法小儿多指手术患者80例,随机均分为:不同剂量Dex组(D1-3组)和对照组(C组)。D1-3组腋路臂丛用药分别为Dex 0.25、0.5、0.75μg/kg+0.25%罗哌卡因0.20 m L/kg,C组为0.25%罗哌卡因0.20 m L/kg。记录阻滞完成、起效、维持及术后苏醒时间及并发症情况。结果 D2组及D3组在起效时间及术后苏醒时间上均比C组短,而维持时间长,D3组比D1组在起效时间及术后苏醒时间上均缩短,而维持时间长。D1-3组的阻滞成功率高于C组,差异有统计学意义(P0.05),D1-3组间无统计学差异。并发症方面,4组未出现血肿病例,各有1例患儿出现喉返神经阻滞,各有1例呼吸抑制,2或3例霍纳综合征,D3组出现1例患儿心率70 min,经处理均安全恢复。结论单纯罗哌卡因或复合Dex臂丛神经阻滞,均可以用于小儿多指手术,中剂量Dex(0.5μg/kg)+0.25%罗哌卡因0.20 m L/kg的配伍较佳。
[Abstract]:Objective to observe the efficacy and safety of different doses of dexmetomidine (Dex) combined with ropivacaine axillary brachial plexus block in pediatric polyfinger surgery. Methods 80 children with polyfinger operation were treated. The axillary brachial plexus of D1-3 group were treated with Dex 0.25 渭 g/kg 0.25 渭 g/kg 0.25% ropivacaine 0.20 mL / kg, respectively. Group C was 0.25% ropivacaine 0.20 mL / kg. Record the complete, effective, maintenance and postoperative recovery time and complications. Results the onset time and postoperative recovery time of D 2 group and D 3 group were shorter than that of C group, while the maintenance time of D 3 group was shorter than that of D 1 group, and the maintenance time of D 3 group was longer than that of D 1 group. The successful rate of block in D 3 group was higher than that in C group. The difference was statistically significant (P0.05), and there was no statistical difference between group D 1-3. In terms of complications, there were no hematoma cases in 4 groups, one case of recurrent laryngeal nerve block in each group, one case of respiratory depression, two or three cases of Horner syndrome, and one case of heart rate 70 min, in group D 3 was safely recovered after treatment. Conclusion ropivacaine alone or combined with Dex brachial plexus block can be used in the operation of multiple fingers in children. The middle dose of ropivacaine (0.5 渭 g/kg) 0.25% ropivacaine 0.20 m L/kg is the best compatibility.
【作者单位】：广东省妇幼保健院麻醉科;
【基金】：广东省科技计划项目(2016ZC0183)
【分类号】：R726.1

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