| Objective:To compare the effects of intravenous and local injection of dexmedetomidine combined with local anesthetic at the same unit of body weight concentration on ultrasound-guided brachial plexus block anesthesia.Methods:A total of 90 patients underwent upper limb surgery under brachial plexus block anesthesia from December 2017 to September 2018,All the patients were American Society of Anesthesiologists(ASA)physical status I-II level.According to the different drugs,the patients were divided into three groups,30 patients in each group were treated with ultrasound-guided brachial plexus block anesthesia: Patients in group C received a local injection of 0.4% ropivacaine(20m L),and intravenous pumping of 60 m L/h normal saline(20m L)was performed at the beginning of the block.In group D,a local injection of 0.4% ropivacaine(20m L)was performed,and 60 m L/h of dexmedetomidine(0.8?g/kg)20m L was injected intravenously at the beginning of the block.Patients in group F received a total of 20 m L of brachial plexus block with 0.4%ropilocaine +0.8?g/kg dexmedetomidine,and 60 m L/h normal saline was pumped intravenously at the beginning of the block.Patients' name,gender,age,body mass index and ASA classification were recorded.Patients' heart rate(HR),blood oxygen saturation(SPO2),mean arterial pressure(MAP),and Ramsay sedation score were recorded at the time of admission(T0),10min(T1),20min(T2),30min(T3),the beginning of surgery(T4),30min(T5),and the end of surgery(T6).The onset time of sensory block,motion block,duration of sensory block and motion block were recorded.Adverse reactions in the three groups were recorded.Results:Changes in vital signs of the patients in the three groups: there was a statistically significant difference in MAP changes between group D,group F and group C at time T1(p<0.05);there was no statistically significant difference between group D and group F(p>0.05);there was statistically significant difference between groups C,D and F at time t2-t6(p<0.05).At time T1,the differences in HR between group D and group C and F were statistically significant(p<0.05);at time t2-t5,the differences were statistically significant(p<0.05);at time T6,the differences between group D and F were statistically significant(p<0.05);at time T6,the differences between group D and F were not statistically significant(p>0.05).Comparison between SPO2 groups showed statistically significant differences between group D at time T2,group C and group F(p < 0.05),between group F at time T4 and group D(p < 0.05),and between group F at time T5 and T6,between group C and group D(p <0.05).Ramsay scores showed no statistically significant difference between the three groups at time T0(p>0.05),and the differences between the two groups at time t1-t6(D and F)and group C(p <0.05).Three groups of patients with sensory blockade effect of time has no statistically significant difference(p > 0.05),C,D and D,F between the two groups motion block work time difference between the two groups has no statistical significance(p > 0.05),between group C and F way motion block work time difference was statistically significant(p <0.05),group C compared with group D,set between duration of sensory block duration and motor block has no statistically significant difference(p > 0.05),group F and C and D compare between two way,sensory block duration and motor block duration extended obviously,the difference was statistically significant(p < 0.05).Conclusion:Compared with intravenous administration,partial application of dexmedetomidine(0.8?g/kg)to brachial plexus block can effectively sedate,maintain hemodynamic stability,shorten the onset time of motion block and prolong the duration of sensory and motion block... |
PDF Full Text Request