臂丛阻滞中用运动感觉分离技术对肌腱修复效果的临床研究

Clinical study of tendon repair with separate anesthesia on motor and sensory fibers in brachial plexus block

目的用布比卡因配伍罂粟碱作运动与感觉分离臂丛麻醉药物,观察对肌腱修复手术设计和张力调整效果的影响。方法53例手外科手术病人随机分为A组(对照组,n=24)和B组(观察组,n=29),臂丛阻滞两组均用0.25%的布比卡因(1.5mg/kg),B组伍用0.0625mg/mL的罂粟碱(0.04mg/kg);比较两组药物对运动感觉阻滞分离程度。根据伤手的主动活动程度,来调整肌腱的张力和长度,彻底松解肌腱粘连。结果两组臂丛感觉神经阻滞无明显差异,运动神经阻滞B组显著轻于A组(P<0.01)。术中彻底松解粘连、肌腱长度调整到生理张力,术后伤指功能恢复良好。结论臂丛阻滞中用运动与感觉分离技术,可使肌腱修复手术中设计的张力和长度更适于术后早期功能训练和康复。

Bupivacaine combined with papaverine block sensory and motor fibers differently in brachial plexus block, which can help to adapt the injured tendon length and tension during operation. 53 cases were randomly divided into group A (control group, n =24) and group B(study group, n =29). Two groups was administered bupivacaine (0.25%, 1.5 mg/kg), however, in group B it also combined with papaverine (0.0625 mg/mL, 0.04 mg/kg). To compare the separate anesthesia on motor and sensory fibers. According to the active motion of injured finger, we can adapt the tendon length and tension. The sensory fibers was blocked simultaneously in two groups. Compared with the control group, the motor fibers can avoided being blocked significantly,the patients can be operated excellently and recovered more satisfactorily in group B (P <0.01). [Conclusions] Bupivacaine combined with papaverine block sensory and motor fibers differently, the patient can be operated excellently and recover satisfactorily.