右美托嘧定复合布托啡诺预防臂丛阻滞止血带反应的疗效观察

发布时间：2018-02-25 22:39

本文关键词： 右美托咪定布托啡诺臂丛阻滞止血带反应　出处：《重庆医学》2017年10期 　论文类型：期刊论文

【摘要】：目的观察右美托咪定复合布托啡诺预防止血带反应的临床效果。方法选择美国麻醉师协会(ASA)Ⅰ~Ⅱ级,臂丛阻滞效果满意的上肢手术患者50例,分为右美托咪定组(A组)和右美托咪定布托啡诺组(B组),每组25例。A组配制方法:200μg右美托嘧定加生理盐水共50mL;B组:200μg右美托嘧定、1mg布托啡诺、生理盐水共50mL。A组以右美托嘧定1μg/kg负荷15min,继以0.4μg·kg~(-1)·h~(-1)维持至术毕;B组给予0.015 mg/kg布托啡诺后按A组方案给药。记录给药前(T0)、止血带充气毕(T1)、15min(T2)、30 min(T3)、45 min(T4)、60 min(T5)、放气后10 min(T6)各时点VAS评分、BIS值、Ramsay镇静评分、心率(HR)、有创血压(MAP)、脉搏氧饱和度(SPO_2)。评估两组患者主观反应分类计数,以及呼吸抑制、心动过缓、低血压情况。T6时点查血气分析评估pH、动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、HCO3-、血乳酸(LAC)。结果两组T4、T5时点VAS评分、BIS值、Ramsay评分、HR、MAP差异有统计学意义(P0.05);A组主观反应表现为佳和差者分别为9、4例,B组为13、1例,两组比较差异有统计学意义(P0.05);两组均无呼吸抑制、心动过缓及低血压;血气分析差异无统计学意义(P0.05);结论右美托咪定复合布托啡诺应用于臂丛麻醉下上肢手术能显著预防止血带反应,效果优于单用右美托咪定。
[Abstract]:Objective to observe the clinical effect of dexmetomidine combined with butorphanol on the prevention of tourniquet reaction. They were divided into two groups: dexmetomidine group (A group) and dexmetomidine butorphenol group (group B). In each group, 25 cases were divided into two groups: group A: 200 渭 g dexmetropyridamole plus normal saline 50mLL, group B: 200 渭 g dexmetropyridamole 1 mg butorphenol. Normal saline 50mL.A group was loaded with dexmetropyridamole 1 渭 g / kg for 15 min, followed by 0.4 渭 g 路kg-1) 路hm-1)) until group B was given 0.015 mg/kg butorphenol after operation, and then administered according to group A regimen. Before administration, T0 was recorded, tourniquet was inflated at 30 min, 30 min, 30 min, 30 min, 30 min, 60 min, 60 min, 10 min, 10 min, respectively, and VAS was evaluated at each time point. BIS score and Ramsay sedation score, Heart rate (HRG), invasive blood pressure mitogen (MAPP), pulse oxygen saturation (SPO), and the classification of subjective responses, respiratory depression and bradycardia were evaluated in the two groups. Blood gas analysis of hypotension. T6 was used to assess pH, Pao 2, Paco 2, Paco 2 and lactic acid in two groups. Results there were significant differences in VAS scores at T4 and T5 and HRMAP in group A (P0.05A, P < 0.05), but no significant difference in HRMAP was found in group A (P < 0.05), which was significantly different from that in group A (P < 0.05), and that in group A was significantly higher than that in group A (P < 0.05), but the subjective response of group A was significantly higher than that of group A (P < 0.05). The good and poor cases were 9 cases and 1 case respectively in group B, 13 cases in group B, 1 case in group B, and 1 case in group B. There was no respiratory inhibition, bradycardia and hypotension between the two groups. Conclusion dexmetomidine combined with butorphanol can significantly prevent tourniquet reaction in upper limb under brachial plexus anesthesia, and the effect is better than that of dexmetomidine alone.
【作者单位】：西南医科大学附属中医医院麻醉科;
【基金】：四川省科技厅-泸州市人民政府-西南医科大学合作项目(14JC0173)
【分类号】：R614

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