舒芬太尼用于臂丛神经阻滞的临床效果观察

Sufentanil adjuvant effects in the axillary brachial plexus blockade

目的观察舒芬太尼用于利多卡因和罗哌卡因复合肌间沟臂丛神经阻滞的麻醉效果。方法急诊单侧上肢外伤手术患者60例,ASAⅠ～Ⅱ级,随机分为两组(n=30):对照组1%利多卡因+0.25%罗哌卡因(25ml),舒芬太尼组1%利多卡因+0.25%罗哌卡因+舒芬太尼15μg(25ml)臂丛阻滞。观察感觉阻滞、运动阻滞和VAS疼痛评分,记录不良反应发生情况。结果两组感觉阻滞起效时间,完全运动阻滞起效时间无明显差异(P>0.05);感觉、运动阻滞持续时间舒芬太尼组明显长于对照组(P<0.05);阻滞后10min、120min、180minVAS评分舒芬太尼组明显低于对照组(P<0.05);麻醉后SBP、DBP和HR变化两组差异无统计学意义(P>0.05);两组无恶心呕吐、瘙痒和呼吸抑制并发症。结论 1%利多卡因+0.25%罗派卡因复合舒芬太尼15μg明显增强臂丛神经阻滞镇痛效果,延长感觉和运动阻滞时间,且没有明显的副作用。

Objective To evaluated the effects of Sufentanil and lidocaine and ropivacaine anesthetic combinations in the brachial plexus.Methods Randomized,prospectic study with 60 patients,ASA status I-II,undergoing hand trauma operation under axillary plexus block,divided into 2 study groups（n=30）：ropivacaine 0.25% ＋ lidocaine1%＋ sufentanil 15 μg（25 ml）（Group sufentanil）,ropivacaine 0.25% ＋ lidocaine1%（25 ml）（Group control）.Onset and duration of sensory and motor block were measured.Visual test simulates（VAS） were evaluated and side effects were recorded.Results Onset time of sensory and motor block showed no significant difference in sufentanil groups than control group（P0.05）.duration time of sensory and motor block in sufentanil groups were longer than control group（P0.05）.At 10min,120min,180min after anesthsia,the VAS score in sufentanil groups were lower than control group（P0.05）,the SBP、DBP and HR were no significant difference between two groups（P0.05）.There were no showed as nausea and vomiting and pruritus and respiratory depression in two groups.Conclusion The use of sufentanil as adjuvant in the brachial plexus block with ropivacaine 0.25% ＋ lidocaine 1% enhance the analgesia and prolong the duration time of sensory and motor block,and no incidence of side effects.