Clinical Observation Of Dexmedetomidine Mixed With Ropivacaine And Lidocaine Used In Combined Lumbar Plexus And Sciatic Nerve Block

Objective To observe the clinical effect of dexmedetomidine combined withropivacaine and lidocaine in ultrasound-guided combined lumbar plexus and sciaticnerve block, to evaluate the safety of dexmedetomidine combined with ropivacaine andlidocaine in ultrasound-guided combined lumbar plexus and sciatic nerve block．Methods40patients in the First Affiliated Hospital of Dalian Medical Universityundergoing the great saphenous vein with high ligation and stripping surgery wereselected, aged31-71, ASAⅠ-Ⅱ, with17male and9female in it. We divided thepatients into experimental group and control group with13cases in each group. Allpatients were monitored when entering the operating room, and received fentanyl0.05mg and midzolam1mg i.v. each. All patients were received lumbar plexuscombined with sciatic nerve block by the same anesthesiologist.0.25%ropivacaine+0.5%lidocaine+dexmedetomidine0.5μg/kg35ml were used in lumbar plexus block and0.5%ropivacaine+1%lidocaine+dexmedetomidine0.5μg/kg15ml were used in sciatic nerveblock in the experimental group, while0.25%ropivacaine+0.5%lidocaine35ml wereused in lumbar plexus block and0.5%ropivacaine+1%lidocaine15ml were used insciatic nerve block in the control group. MAP, HR, SpO2were observed at the time ofbefore anesthesia(T0),10minutes after anesthesia(T1), the beginning of theoperation(T2),1hour after anesthesia(T3) and the end of the operation(T4) each. The on set time of sensory and motor block and the duration of the sensory and motor blocktime were observed. Side effects were observed and recorded.Result①There were two bradycardiac cases in the experimental group whomtreated with atropine0.4-0.8mg and turned better. One patient in the control group feltpain and treated with fentanyl0.15mg and turned better.②MAP and HR at T1,T2,T3were lower than T0in the experimental group, MAP and HR in T1-T4in theexperimental group were lower than that at the same time point in the control group, thedifferences were statistically significant(P<0.05or P<0.01).③The duration of thesensory and motor blockade time were longer in the experimental group than in thecontrol group, and the differences were statistically significant(P<0.01).Conclusion Dexmedetomidine mixed with ropivacaine and lidocaine can used incombined lumbar plexus and sciatic nerve block safely, and dexmedetomidineprolonged the duration of sensory and motor block.