两种不同容量罗哌卡因用于肌间沟臂丛神经阻滞的临床观察

Clinical observation on interscalene brachial plexus block with ropivacaine of two different volumes

目的:比较不同容量罗哌卡因在肌间沟臂丛神经阻滞中的效果和并发症发生情况。方法:将36例实施肌间沟臂丛神经阻滞术择期行上肢手术的病人随机分为A、B组,每组18例,分别接受0.375%罗哌卡因40 ml和0.375%罗哌卡因30 ml。麻醉实施后,观察并记录尺神经、正中神经、桡神经支配区域感觉阻滞(针刺法)的起效时间和阻滞的完善时间、运动阻滞程度(James评分)、镇痛的持续时间和并发症发生情况。结果:A、B组受试者感觉阻滞的起效时间分别为(2.01±1.09)min、(1.93±1.22)min;感觉阻滞完善时间分别为(9.05±3.58)min、(9.55±3.51)min;运动阻滞完善时间分别为(14.7±4.3)min、(14.9±4.2)min;2组镇痛持续时间差异无统计学意义;霍纳综合征发生率分别为22.2%、5.6%,未发生其它并发症。结论:罗哌卡因30 ml是成人肌间沟臂丛神经阻滞的合适容量。

Objective： To compare the block effect and complications with different volumes of ropivaeaine by interscalene brachial plexus block. Methods： A total of 36 adult patients undergoing upper limb surgery were allocated to receive 40 ml of 0. 375% ropivacaine and 30 ml of 0. 375% ropivacaine respectively. The onset time and complete time of sensory blockade of ulner nerve, medial nerve and radial nerve; duration of analgesia; satisfaction degree of nerve block and complications were recorded. Results： The onset time of sensory blockade in two groups were （2.01±1.09） min, （1.93±1.22） rain respectively. Complete time of movement were （14.7±4.3） rain, （14.9±4.2） rain respectively. Duration of analgesia were 11 h. Horner＇s syndrome in two groups were 22.2%, 5.6% respectively. Conclusions： In this study , ropivacaine 30 ml may be suitable volume for interscalene brachial plexus block in adult patients.