两种剂量的右美托咪定作为左旋布比卡因佐剂用于锁骨下臂丛神经阻滞中的疗效比较：前瞻性双盲随机对照试验

以下文章来源于罂粟花 ，作者anesthGH

本文由“罂粟花”授权转载

两种剂量的右美托咪定作为左旋布比卡因佐剂用于锁骨下臂丛神经阻滞中的疗效比较：前瞻性双盲随机对照试验

贵州医科大  麻醉与心脏电生理课题组

翻译：邓举

编辑：柏雪

审校：曹莹

背景：

这项前瞻性、双盲、随机、对照试验比较了两种剂量右美托咪定（50μg和100μg）联合左旋布比卡因对行锁骨下臂丛神经阻滞后感觉阻滞持续时间的影响。我们假设神经周围右美托咪定会剂量依赖性地延长感觉阻滞持续时间。

方法：

该研究包括60名年龄在20-60岁的ASA I/II并接受前臂和手部手术的患者。患者被随机分为三组，在超声引导下进行锁骨下臂丛神经阻滞（n=20）。L组给予35mL0.5%左旋布比卡因加生理盐水，LD50组35mL0.5%左旋布比卡因加50μg右美托咪定，LD100组35mL0.5%左旋布比卡因加100μg右美托咪定。记录患者感觉阻滞的开始时间和持续时间、术后补加镇痛药的时间以及术后24小时吗啡总需药量。

结果：

LD100组感觉阻滞持续时间（15.55±1.1 h，95% CI15.04-16.06h）比LD50组（12.8±1.2 h；95% CI，12.24–13.36 h）（p<0.001）及L组（95%CI，9.46–10.44 h）长(p<0.001）。与LD50组和L组相比，LD100组要求术后补加镇痛药的时间更长，术后需要的吗啡剂量也更少（P<0.001）。

结论：

右美托咪定作为左旋布比卡因的佐剂，使用100μg比50μg的感觉阻滞持续时间更长。

原始文献来源：

Huda F. Ghazaly, Ahmed Alsaied A. Aly, Zaher Zaki Zaher,et al.Comparison of the efcacy of two doses of dexmedetomidine as an adjunct to levobupivacaine in infraclavicular brachial plexus block: prospective double-blinded randomized controlled trial［J］.BMC Anesthesiology (2022) 22:338 .

英文原文：

Comparison of the efcacy of two doses of dexmedetomidine as an adjunct to levobupivacaine in infraclavicular brachial plexus block: prospective double-blinded randomized controlled trial

Abstract

Background: This prospective, double-blind, randomized, controlled trial compared the efficacy of two dexmedetomidine doses (50 and 100-μg) combined with levobupivacaine on sensory block duration in infraclavicular brachial plexus block. We hypothesized that perineural dexmedetomidine would extend sensory block duration dose-dependently.

Methods: The study included 60 patients aged 20 to 60 years of both sex with an ASA I/II undergoing forearm and hand surgery. The patients were randomly assigned into three equal groups (n=20) for ultrasound-guided infraclavicular brachial plexus block. The L group received 35-mL 0.5% levobupivacaine plus normal saline, the LD50 group received 35-mL 0.5% levobupivacaine plus 50-μg dexmedetomidine, and the LD100 group received 35-mL 0.5% levobupivacaine plus 100-μg dexmedetomidine. Patients were investigated for onset and duration of sensory blockade, time to frst postoperative rescue analgesia, and the total 24-h postoperative morphine requirement.

Results: The LD100 group had a longer sensory block duration (15.55±1.1 h; 95% confdence interval (CI), 15.04– 16.06) than the LD50 group (12.8±1.2 h; 95% CI, 12.24–13.36 h) (p<0.001) or the L group (9.95±1.05 h; 95% CI, 9.46–10.44 h) (p<0.001). The LD100 group took longer to request postoperative rescue analgesia and required fewer postoperative morphine doses than the LD50 and L groups (P<0.001).

Conclusions: Sensory block duration was longer with perineural 100-μg dexmedetomidine as an adjunct to levobupivacaine than with 50-μg dexmedetomidine.

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本公众平台所刊载原创或转载内容不代表米勒之声的观点或立场。文中所涉及药物使用、疾病诊疗等内容仅供医学专业人士参考。

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编辑：Michel.米萱

校对：MiLu.米鹭

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