ABSTRACT
Objective To investigate the effects of dexmedetomidine on sedation and inflammatory response in patients undergoing brachial plexus anesthesia, to provide a reference for the selection of sedative drugs in forearm traumatic patients undergoing brachial plexus block anesthesia .Methods 80 forearm traumatic patients underwent trauma surgery with brachial plexus nerve block from July 2015 to June 2016 were selected and randomly divided into two groups of dexmedetomidine group (dexmedetomidine group, D group) and normal saline group (control group, C group), each group of 40 cases.The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO2) were recorded before operation (T0), incision (T1), 15 min (T2), 30 min (T3).Interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α) were measured at different time points. At the same time, the Ramsay sedation score and the degree of amnesia after operation were measured.Results There were no significant differences in MAP, HR and SpO2 before anesthesia between the two groups.In group D, MAP and HR were significantly lower than those in group C at T1, T2, T3 and T4, the difference was statistically significant (P<0.05).There was no statistical difference in SpO2 between the two groups.The Ramsay sedation score of group D at T1 to T4 was significantly higher than that of group C, the difference was statistically significant (P<0.05).The levels of IL-1β, IL-6 and TNF-αin group D were significantly lower than those in group C at T1 to T4, the difference was statistically significant (P<0.05).Conclusion Dexmedetomidine has good curative effect on forearm traumatic patients with brachial plexus block and less hemodynamics changes , which is beneficial to patients'forgotten of operation and inhibition of inflammatory reaction in forearm traumatic patients.
ABSTRACT
Objective To compare the analgesic effect and motor function of epidural analgesia and continuous adductor canal block in the elderly patients with internal malleolus fracture,in order to provide a reference for the choice of postoperative analgesia.Methods A total of 80 patients aged 65-74 years were enrolled in this study.They were randomly divided into adductor canal block group (T group,n =40) and epidural block group (C group,n =40) by computer random software.The T group underwent laryngeal mask intubation with general anesthesia + ultrasound guided transnasal saphenous nerve block.The C group underwent epidural anesthesia.The systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart rate (HR) were measured before anesthesia (T0),10 minutes after anesthesia (T1),30 minutes after operation (T2),before leaving OR (T3).Visual analogue (VAS) was recorded immediately before leaving OR,2h,6h,12h,24h and 48h after operation.The incidence of complications such as hypotension,ephedrine use,postoperative urinary retention and other anesthesia-related complications were also recorded.Results The SBP and DBP were significantly higher in the T group at T1,T2 and T3 than those in group C (t =5.069,3.087,3.019,5.659,2.744,2.254,all P ＜ O.05).The HR was lower in the T group at T1 and T2 than those in the C group (t =4.138,3.797,all P ＜ 0.05).There were no statistically significant differences in VAS between the two groups at 2h,6h,12h,24h and 48h postoperatively (all P ＞ 0.05).The incidence of intraoperative hypotension (7 cases),ephedrine use (6 cases) and postoperative urina-ry retention (12 cases) were significantly higher in the C group than those in the T group (0 cases,O cases,1 cases,x2 =11.11,P ＜0.05).Conclusion Compared with epidural anesthesia,ultrasound-guided adductor canal block anesthesia can maintain hemodynamics stability in elderly patients with internal malleolus fracture,it can provide the same analgesic effect as epidural analgesia,and has no effect on the motor function of the contra lateral limbs and can reduce the risk of postoperative complications.