标题：右美托咪定复合罗哌卡因在小儿腋路臂丛神经阻滞中的临床应用

      作者：杨海扣，周 静，孙 剑，陈华军
    (淮安市妇幼保健院麻醉科，江苏 淮安 223002)

      卷次： 2015年26卷23期

      【摘要】 目的 观察右美托咪定复合罗哌卡因在小儿腋路臂丛阻滞中的应用效果。方法 30例择期进行
上肢手术患儿随机分为R组(n=15)和RD组(n=15)，R组用0.3%罗哌卡因行腋路臂丛神经阻滞，RD组则使用0.3%
罗哌卡因复合右美托咪定1 ?g/kg。记录术后不同时间点FLACC变化；观察臂丛神经阻滞起效和镇痛持续时间，
并记录不良反应。结果 与R组比较，RD组患者术后4 h、6 h、8h、10 h FLACC评分降低，差异均有统计学意义
(P<0.05），罗哌卡因臂丛神经阻滞起效时间缩短，镇痛时间明显延长，差异均有统计学意义(P<0.05)，RD组有1例
出现心动过缓。结论 右美托咪定1 μg/kg复合0.3%罗哌卡因用于小儿腋路臂丛神经阻滞时可以延长罗哌卡因
的神经阻滞时间，术后镇痛效果好，但可能导致心动过缓。

      【关键词】 罗哌卡因；右美托咪定；臂丛神经阻滞；小儿

      【中图分类号】 R614.4 【文献标识码】 A 【文章编号】 1003—6350（2015）23—3481—03


Application of ropivacaine combined with dexmedetomidine in children with brachial plexus nerve block.
YANG
Hai-kou, ZHOU Jing, SUN Jian, CHEN Hua-jun. Department of Anesthesiology, Maternal & Child Health Care Hospital
of Huaian City, Huaian 223002, Jiangsu, CHINA

【Abstract】 Objective To investigate the effect of ropivacaine combined with dexmedetomidine in children
with brachial plexus nerve block. Methods Thirty children who underwent upper limb operation were randomly allo-
cated into two groups (n=15). Group R received 0.3% ropivacaine through brachial plexus nerve block, while group
RD received 0.3% ropivacaine combined with 1 μg/kg of dexmedetomidine. The FLACC score was recorded at 1 h,
2 h, 4 h, 6 h, 8 h, 10 h, 12 h after operation. The onset time and duration of analgesia were recorded, and the complica-
tions were assessed. Results Compared with group R, FLACC score of group RD at 4 h, 6 h, 8 h, 10 h was signifi-
cantly lower (P<0.05). The onset time of block was shorter, and the duration of analgesia was longer in group RD (P<
0.05). Bradycardia was observed in one patient in group RD. Conclusion 0.3% ropivacaine combined with 1 μg/kg
of dexmedetomidine can prolong the duration of analgesia in children with brachial plexus nerve block. However, it
may lead to bradycardia.