利多卡因复合罗哌卡因不同给药方式对坐骨神经阻滞起效时间的影响

Effect of lidocaine-ropivacaine with different administrations on the onset time of sciatic nerve block

目的观察利多卡因复合罗哌卡因不同给药方式对坐骨神经阻滞起效时间的影响。方法选择60例行单侧下肢手术的病人,随机分为A、B两组,每组30例。采用神经刺激器定位行单侧腰丛-坐骨神经阻滞。A组坐骨神经给药方式为注射1%的利多卡因和0.375%罗哌卡因混合液20ml;B组坐骨神经给药方式为先注射2%利多卡因10ml,然后注射0.75%罗哌卡因10ml。测定两组病人麻醉后腓肠神经外侧皮支(SN)、腓浅神经(FN)、胫神经跟内侧支(TN)的起效时间,并观察术中的麻醉效果。结果A组病人的SN和FN起效时间快于B组(P<0.05),A、B两组TN起效时间无统计学差异。SN、FN起效时间小于10分钟的例数比较,A组大于B组(P<0.05)。两组患者麻醉效果优秀率比较无显著差异(P>0.05)。结论在相同的局麻药用量下,坐骨神经阻滞采用2%利多卡因和0.75%罗哌卡因混合注射的方式起效快,是较好的临床给药方式。

Objective To observe the effect of lidocaine-ropivacaine with different administrations on the onset time of sciatic nerve block. Methods Sixty patients for unilateral lower limb surgery under sciatic nerve combined lumbar plexus block were randomly divided into two groups： group A （n=30） and group B （n=30）. Group A recieved 20ml of the mixture solution of 1% lidocaine and 0.375% ropivacaine for sciatic nerve; Group B recieved 2% lidoeaine ,10ml and 0.75% ropivaeaine 10ml in order . The onset time of lateral cutaneous branch of sural nerve （SN）, superficial peroneal nerve （FN）,rami calcanei mediales nervi tibialis （TN） and the number of cases in which onset time was less than 10 minutes or 15 minutes were recorded respectively. Results The onset time of SN and FN in group A was faster than that in group B （P〈0.05）, The number of cases in group A whose onset time of SN and FN was less than 10 minutes were more than that in group B. There was no significant difference in the blockade effect between the two groups. Conclusion With the same dosage of local anesthetic, the onset time using the mixture solution of lidocaine and ropivacaine is faster in sciatic nerve block, The administrations of mixture is more suitable in clinics.