摘要
目的 观察比较不同浓度罗哌卡因在老年患者超声引导下臂丛神经阻滞中的效果,评价其有效性和安全性,确定老年患者臂丛神经阻滞的最佳麻醉剂用量。方法 选取该院2013年2月至2014年12月收治的美国麻醉医师学会（ASA）Ⅰ-Ⅱ级的择期行上肢手术的老年患者120例,随机分为A、B、C、D 4组,A、B、C、D组在B超引导下分别使用0.250%、0.375%、0.500%、0.750%的罗哌卡因30mL进行麻醉。观察记录感觉阻滞起效时间、运动阻滞程度、镇痛持续时间和并发症等。结果随着罗哌卡因浓度的增加麻醉起效时间变快,镇痛维持时间更长,其中0.375%、0.500%和0.750%罗哌卡因与0.250%的罗哌卡因比较差异有统计学意义（P〈0.05）,而0.375%,0.500%和0.750%罗哌卡因组间差异无统计学意义（P〉0.05）。4组患者麻醉后均未出现严重并发症。结论 0.375%以上浓度的罗哌卡因在B超引导下对老年人行臂丛神经阻滞均能达到满意的临床效果。
Objective To observe and compare the effect of different concentration of ropivacaine on elderly patient with brachial plexus block under ultrasound-guided,to assess its effectiveness and security, so as to determine the optimum dosage of anesthetic for elderly patients with brachial plexus block. Methods 120 patients undergoing elective surgery of forearm or hand in this hospital from February 2013 to December 2014 were selected as the observation group m this study. These patients were randomly divided into four groups on average, narcosis was conducted in each group with ultrasound-guided;group A with 30 mL of 0. 250 % ropivacaine,group B with 30 mL of 0. 375% ropivacaine,group C with 30 mL of 0. 500% ropivacaine,group D with 30 mL of 0. 750 % ropivacaine. The onset time of sensory block, motor block level,duration of analgesia and adverse reactions were observed and recorded. Results With the increase of concentration of ropivacaine,the onset time of narcotize became shorter（P〈0.05） and duration of analgesia became longer（P〈 0.05）. There were no significant difference in the effects of brachial plexus block（P〈 0.05）. There was no complications occurred in four groups after narcosis. Conclusion Concentration of ropivacaine more than 0. 375 % can achieve perfect clinical effect on elderly patients with brachial plexus block under guidance of ultrasound.
出处
《重庆医学》
CAS
北大核心
2016年第1期53-55,共3页
Chongqing medicine
基金
2014年浙江省医药卫生科技计划项目(2014KYB280)
关键词
罗哌卡因
超声引导
臂丛神经阻滞
老年患者
有效性
ropivacaine
ultrasound-guided
brachial plexus block
eldeoly patients
effective
