摘要
目的比较不同浓度罗哌卡因用于超声引导下肌间沟臂丛神经阻滞的麻醉效果。方法拟行上肢手术患者60例，随机均分为A组、B组和C组，采用超声引导下肌间沟臂丛神经阻滞，A组、B组和C组分别给予0．3％、0．4％、0．5％的罗哌卡因30ml。观察并评价注药后15、30min臂丛各主要神经的痛觉阻滞效应、运动阻滞程度，记录麻醉效果、麻醉维持时间、运动阻滞恢复时间。结果注药后15minA组、B组和C组各神经痛觉完全阻滞例数依次递增，C组肌皮神经、桡神经、正中神经和尺神经完全阻滞例数明显多于A组（P〈0．05），C组运动阻滞3级（不能屈肘）例数明显多于A组（P〈0．05）；注药后30minB组和C组运动阻滞4级（不能屈腕）例数明显多于A组（P〈0．01）。A组优16例（80％），良4例（20％）；B组优18例（90％），良2例（10％）；C组优18例（90％），良2例（10%），三组差异无统计学意义。B组和C组镇痛持续时间和运动阻滞恢复时间明显长于A组（P〈0．05或P％0．01）。结论0．3％～0．50o的罗哌卡因30ml用于超声引导下肌间沟臂丛神经阻滞麻醉，均可达到理想的臂丛神经阻滞效果，随着浓度增加，麻醉起效加快而阻滞持续时间延长。
Objective To compare the efficacy and safety of interscalene brachial plexus block by ultrasound-guided with ropivacaine of different concentrations. Methods Sixty patients undergoing upper limb surgery, were randomly divided into three groups, Patients in groups A, B and C were received the interscalene brachial plexus block by ultrasound-guided with 0. 3%, 0.4%, 0.5 % ropivacaine 30 ml respectively. The sensory and motor block, the degree of motor block, effects of blockade and duration of analgesia were recorded and evaluated. Results After injection 15 min, A, B, C three groups of nerve pain completely block the number of cases increased. The musculoeutaneous nerve, median nerve, radial nerve and ulnar nerve, completely block in group C were significantly more than those in group A （P〈0.05）, The motor block level 3 of group C were significantly more than those in group A （P〈0. 05）. After the injection of 30 min, A, B, C three groups of nerve pain completely block number of similar cases, there was no significant difference. The motor block level 4 of group B and group C were more than those in group A （P〈0.01）. The anesthesia effect of this three group, the excellent and good rate was similar. Compared with group A, the duration of analgesia and motor block recovery time in group B and group C were significantly prolonged （P〈0.05 or P〈0.01）. In 16 cases of group A, and （80%）, good in 4 cases （20%）; group B was excellent in 18 cases （90%）, good in 2 cases （10%） ; group C was excellent in 18 cases （90%）, good in 2 cases （10%）, no statistically significanty significant difference between the three groups. Conclusion Ultrasound-guided intersealene brachial plexus block with 30 ml of 0.3%-0.5% ropivacaine can provide excellent block, high concentration ropivacaine can shorten the onset time and prolong the duration of analgesia and motor block time.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2014年第5期472-475,共4页
Journal of Clinical Anesthesiology
基金
广东省清远市科技项目(项目编号:2012B011204093)
关键词
罗哌卡因
超声引导
肌间沟
臂丛
神经阻滞
Ropivacaine
Ultrasound guidance
Interscalene
Brachial plexus
Nerve block
