罗哌卡因复合布托啡诺连续臂丛神经阻滞用于上肢手术术后镇痛的研究

Study of ropivacaine combined with butorphanol through continuous brachial plexus block for postoperative analgesia in the upper limb surgery

目的探讨罗哌卡因复合布托啡诺连续臂丛神经阻滞用于上肢手术术后镇痛的安全性和有效性。方法选取择期行上肢手术的患者50例,随机分成罗哌卡因复合布托啡诺组(B组)和罗哌卡因组(R组),每组各25例。在神经刺激仪引导下行肌间沟臂丛神经阻滞,定位满意后,B组注入0.375%罗哌卡因加1 mg布托啡诺混合液20 ml,R组注入0.375%罗哌卡因20 ml,置入套管并固定。术毕通过该套管连接电子镇痛泵行患者自控镇痛。观察并记录两组患者术毕即刻,术后2、4、8、24、48 h疼痛程度[采用视觉模拟评分法(VAS)],记录两组患者镇痛泵的有效按压次数及恶心、呕吐、瘙痒、呼吸抑制等不良反应的发生率。结果术毕即刻、术后2、4、8、24、48 h,B组的VAS评分明显低于R组(P<0.05)。两组均无明显不良反应。结论罗哌卡因复合布托啡诺连续臂丛神经阻滞可增强术后镇痛效果,无明显不良反应,是一种安全有效的镇痛方法。

Objective To discuss the safety and effectiveness of ropivacaine combined with butorphanol through contin- uous braehial plexus block （CBPB） for postoperative analgesia in the upper limb surgery. Methods 50 patients sched- uled for the upper limb surgefiy were evenly and randomly divided into the ropivacaine combinined with butorphanol group （the group B） and the ropivacaine group （the group R）.The intersealene hraehial plexus block was performed by the guidance of nerve stimulator.After a proper location,20 ml mixture of 0.375% ropivaeaine combined with 1 mg bu- torphanol was injected in the group B and only 0.375% ropivacaine of 20 ml was used in the group R,and the cannuia was inserted and fixed.The postoperative patient-controlled analgesia （PCA） was conducted by the cannula connecting with PCA pump.Pain degree in right-away,2 h,4 h,8 h,24 h and 48 h after surgery was observed and recorded by visual analogue scale （VAS） respectively.The incidence rate of adverse reactions like effective press times of PCA pump,nau- sea,vomit,pruritus and respiratory depression etc. were recorded in the two groups. Results The VAS score in right- away,2 b,4 h,8 h,24 h,and 48 h after surgery in the group B was remarkably lower than that in the group R （P〈0.05） respectively.There was no obvious adverse reaction in the two groups. Conclusion Combination of ropivacaine and bu- torphanol through for CBPB can enhance postoperative analgesia without evident adverse reactions which is a safe and effective method for analgesia.