上肢手术锁骨上臂丛神经阻滞术中布比卡因联合右美托咪定与布比卡因联合氯尼替丁的比较研究

KALLURI SAIPRIYANKA, NAGAJYOTHI J
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摘要

目的比较克洛尼定与右美托咪定作为布比卡因的辅助用药在锁骨上臂丛神经阻滞下进行上肢手术患者中的疗效:这是一项在一家三级医疗机构麻醉科进行的前瞻性比较研究。研究共纳入了 80 名接受各种上肢手术的患者。根据患者在接受锁骨上阻滞时是使用氯尼替丁(C 组)还是右美托咪定(D 组)作为布比卡因的辅助用药,将他们分为两组。比较两组患者的起效时间、感觉和运动阻滞持续时间、镇痛持续时间、麻醉质量、血液动力学和不良反应,P<0.05 为差异有统计学意义:结果:C 组和 D 组病例的性别分布相当,差异无统计学意义。两组患者的平均年龄相当,无明显差异(P=0.5671)。研究病例中最常见的手术类型是桡骨下端和尺骨(28.75%),其次是肱骨下端(21.25%)、桡骨上端和尺骨(20%)。与 C 组相比,D 组的感觉和运动阻滞平均持续时间以及镇痛持续时间更长,差异具有高度统计学意义(P<0.0001)。接受右美托咪定治疗的患者的麻醉质量优于接受氯尼替胺和布比卡因治疗的患者:结论:右美托咪定作为布比卡因的辅助用药用于臂丛神经阻滞时,与使用氯尼替胺作为辅助用药相比,可延长感觉和运动阻滞持续时间以及镇痛持续时间。它还能提高麻醉质量。
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COMPARATIVE STUDY OF BUPIVACAINE WITH DEXMEDETOMIDINE VERSUS BUPIVACAINE WITH CLONIDINE FOR SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB SURGERIES
Objective: To compare the efficacy of clonidine with dexmedetomidine as an adjunct to bupivacaine in patients undergoing upper limb surgeries under supraclavicular brachial plexus block. Methods: This was a prospective comparative study conducted in the department of anesthesiology of a tertiary care medical institute. 80 patients undergoing various upper-limb surgeries were included in this study. Patients were divided into two groups on the basis of whether they received Clonidine (Group C) or Dexmedetomidine (Group D) as an adjuvant to Bupivacaine for supraclavicular block. The onset as well as duration of sensory and motor blockade, duration of analgesia, quality of anesthesia, hemodynamics, and adverse effects were compared between the two groups. p<0.05 was considered statistically significant. Results: The gender distribution of cases in Group C and Group D was found to be comparable, with no statistically significant difference. The mean age of patients in both groups was found to be comparable with no significant difference (p=0.5671). The most common types of surgeries in the studied cases were those of the lower radius and ulna (28.75%), followed by the lower humerus (21.25%), upper radius, and ulna (20%). The mean duration of sensory and motor block and duration of analgesia were found to be higher in group D as compared to group C, and the difference was found to be statistically highly significant (p<0.0001). The quality of anesthesia was better in patients who received dexmedetomidine as compared to those who received clonidine with Bupivacaine. Conclusion: Dexmedetomidine used as an adjuvant with bupivacaine for brachial plexus block is associated with prolonged duration of sensory as well as motor block and duration of analgesia as compared to when clonidine is used as an adjuvant. It is also associated with a better quality of anesthesia.
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