Evaluation Of Dexmedetomidine Compound With Ropivacaine Brachial Plexus Block For Perioperative Analgesia In Children

Objective:Clinical pediatric hand trauma surgery commonly used local anesthetic method for brachial plexus block by using lidocaine anesthesia as usual,but the duration is short,not conducive to children with peri operative pain management,therefore,in order to prolong the duration of analgesia in children with hand injury,we used dexmedetomidine compound with ropivacaine administration method to improve children perioperative analgesia.This study compared the effects of ropivacaine and dexmedetomidine combined with ropivacaine on brachial plexus block anesthesia in pediatric perioperative analgesia.Methods:We choose 30 cases of hand trauma in children,aged 2-6 years old,weighing 7-25 kg,ASAI or II,4 weeks no respiratory tract infection before surgery,no surgical contraindication.Using a random number table,the patients were randomly divided into ropivacaine group and dexmedetomidine combined with ropivacaine group,with 15 cases in each group.The children were treated with inhalation of 8% sevoflurane in the mask,and the laryngeal mask was inserted into the laryngeal mask after successful inhalation anesthesia.The spontaneous breathing was maintained and the sevoflurane was adjusted to 3%.Atropine 0.15mg/kg and dexamethasone 0.2mg/kg were injected.Then nerve stimulator guided axillary brachial plexus block was carried on.Ropivacaine Group received 0.25% ropivacaine 1ml/kg,dexmedetomidine group received 0.25% ropivacaine 1ml/kg compound with dexmedetomidine 1?g/kg.2% sevoflurane was inhaled untill the end of surgery.Two groups of children with brachial plexus block onset time were recorded after brachial plexus analgesia duration.The occurrence time of brachial plexus block,the duration of brachial plexus analgesia and the incidence of postoperative agitation in two groups were recorded.Results:In ropivacaine group and dexmedetomidine compound with ropivacaine group,the differences in age,weight,gender and the operation time were not significant(P > 0.05);In ropivacaine group of brachial plexus block,the onset time was(13±3.5)min,in dexmedetomidine compound with ropivacaine group of brachial plexus block,the onset time is(10.4 ± 2.3)min(P < 0.05);In ropivacaine group,the recovery time was(13.1 ±8.7)min,in dexmedetomidine compound with ropivacaine group,the recovery time was(13.5 ± 2.4)min(P >0.05);dexmedetomidine compound with ropivacaine group analgesia time was significantly more than ropivacaine group(P < 0.05);The FLACC score of ropivacaine group and dexmedetomidine compound with ropivacaine group was significantly different(P < 0.05);dexmedetomidine compound with ropivacaine group operation analgesia time were significantly more than ropivacaine group(P < 0.05);The postoperative agitation rate in ropivacaine group was 53.33%,dexmedetomidine compound with ropivacaine group the postoperative agitation rate was 20%(P < 0.05);In ropivacaine group 3 cases of children were vomitted,the incidence rate of adverse reaction was 20%,in dexmedetomidine compound with ropivacaine group,1 cases of vomiting occured,the incidence of adverse reaction was 6.67%(P <0.05).During the operation,no other adverse reactions.Conclusion:Dexmedetomidine combined with ropivacaine for brachial plexus block can shorten the onset time of the brachial plexus,prolong the duration of analgesia,does not affect the recovery time.In the dexmedetomidine combined with ropivacaine group,FLACC score decreased,the analgesic effect was more obvious.At the same time,it dose not increase adverse reactions.For children with hand injury in perioperative analgesia,it is safe and effective.