重庆医学2017，Vol.46Issue(10)：1339-1342,4.DOI:10.3969/j.issn.1671-8348.2017.10.013
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
Observation on efficacy of dexmedetomidine combined with butorphanol in preventing brachial plexus block tourniquet reaction
摘要
Abstract
Objective To observe the clinical effect of dexmedetomidine combined with butorphanol in preventing tourniquet reaction.Methods Fifty patients(ASA Ⅰ-Ⅱ)with upper limb operation and satisfactory effect of brachial plexus block were randomly divided into the dexmedetomidine group(A)and dexmedetomidine combined with butorphanol group (B),25 cases in each group.The anesthesia drug preparation method in the group A:dexmedetomidine 200μg was added with normal saline 50 mL;in the group B:dexmedetomidine 200 μg,butorphanol 1 mg and normal saline 50 mL altogether.The group A used dexmedetomidine 1 μg/kg load for 15 min and maintained by 0.4 μg · kg-1 · h-1 until the end of operation;the group B was given 0.015 mg/kg butorphanol,then was given medication according the scheme of group A.The VAS score,BIS value,Remsay sedation score,HR,MAP and SPO2 were recorded at the time points:before medication (T0),immediately after the tourniquet inflation (T1),15 min (T2),30 min (T3),45 min (T4),60 min after tourniquet inflation (T5) and 10 min after deflation (T6).The subjective response classification count,respiratory depression,bradycardia and hypotension in the two groups were assessed.pH,PaO2,PaCO2,HCO3-and LAC at T6 were evaluated by theblood gas analysis.Results The VAS score,BIS value,Ramsay sedation score,HR and MAP at T4,T5 had statistical difference between the two groups (P＜0.05).In the group A,the good and poor subjective responses had 9 cases and 4 cases respectively,which in the group B had 13 cases and 1 case,the difference was statistically significant (P＜0.05);there was no respiratory depression,bradycardia and hypotension in the two groups;the blood gas analysis showed no statistical difference between the two groups.Conclusion Applying dexmedetomidine combined with butorphanol in upper and lower limb surgery under brachial plexus anesthesia can significantly prevent the tourniquet reaction,its effect is superior to single use of dexmedetomidine.关键词
右美托咪定/布托啡诺/臂丛阻滞/止血带反应Key words
dexmedetomidine/butorphanol/brachial plexus block/tourniquet reaction分类
医药卫生引用本文复制引用
唐海斌,刘庆,张英..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[J].重庆医学,2017,46(10):1339-1342,4.基金项目
四川省科技厅-泸州市人民政府-西南医科大学合作项目(14JC0173). （14JC0173）
