The block effect of Dexmedetomidine combined with Ropivacaine in the external bundle posterior bundle and internal bundle of subclavian brachial plexus
JIANG Qi YANG Jin-hui ZHOU Li-hua XIN Dian WU Bao-hua
Department of Anesthesiology,Guangzhu Orthopedics Hospital,Guangzhou in Guangdong Province,Guangzhou 510045,China
Abstract:Objective To investigate the block effect of Dexmedetomidine combined with Ropivacaine in the external bundle,posterior bundle and internal bundle of subclavian brachial plexus.Methods From June 2015 to June 2016,58 patients who underwent orthopedic surgery under the elbow joint of upper extremity in our hospital were randomly divided into two groups,dexmedetomidine combined ropivacaine group(DR group)and pure ropivacaine group(R group),29 cases in each group.The two groups were positioned 2 cm below the coracoid process.After the nerve stimulator induced the external bundle,the posterior bundle and the internal bundle,the DR group and the R group were injected with 0.5 μg/kg of Dexmedetomidine combined with 150 mg of Ropivacaine and 150 mg of Ropivacaine,with a capacity of 30 ml.Each bundle was injected with 10 ml.Postoperative sensory and motor block and intraoperative comfort rating were recorded in both groups.The incidence of adverse reactions was recorded in both groups.Results There was no significant difference in motor block time between the two groups(P>0.05).The onset time,onset time and duration of motor block in DR group were better than those in R group (P<0.01).The proportion of comfort grade 1(100.0%)in DR group was higher than that in R group (86.2%),the difference was statistically significant(P<0.05).There were no adverse reactions such as bradycardia,hypotension,respiratory depression,nausea and vomiting between the two groups(P>0.05).Conclusion Dexmedetomidine can shorten the onset time of anesthesia and prolong the duration of sensory block,and improve the comfort during the surgery.
Brummett CM,Norat MA,Palmisano JM,et al.Perineural administration of dexmedetomidine in combination with bupivacaine enhances sensory and motor blockade in sciatic nerve block without inducing neurotoxicity in rat[J].Anesthesiology,2008,109(3):502-511.
[7]
Ammar AS,Mahmoud KM.Ultrasound-guided single injection infraclavicular brachial plexus block using bupivacaine alone or combined with Dexmedetomidine for pain control in upper limb surgery:A prospective randomized controlled trial[J].Saudi J Anaesth,2012,6(2):109-114.
[8]
Erlancher W,Schuschnig C,Orlicek F,et al.The effects of Clonidine on Ropivacaine 0.75%in axillary perivascular brachial plexus block[J].Acta Anaesth Scand,2000,44(1):53-57.
[9]
Brummett CM,Hong EK,Janda AM,et al.Perineural Dexmedetomidine added to Ropivacaine for sciatic nerve block in rats prolongs the duration of analgesia by blocking the hyperpoarization-activated cation current[J].Anesthesiology,2011,115(4):836-843.
[10]
Marhofer D,Kettner SC,Marhofer P,et al.Dexmedetomidine as an adjuvant to Ropivacaine prolongs peripheral nerve block:a volunteer study[J].Br J Anaesth,2013,110(3):438-442.
[11]
Rancourt MP,Albert NT,Cote M,et al.Posterior tibial nerve sensory blockade duration prolonged by adding Dexmedetomidine to Ropivacaine[J].Anesth Analg,2012,115(4):958-962.
[12]
Nelson LE,Lu J,Cuo TZ,et al.The α2-Adrenoceptor agonist dexmedomidine converges on an endogenous sleeppromoting pathway to exert its sedative effects[J].Anesthesiology,2003,98(2):428-436.