芬太尼应用于臂丛神经阻滞的镇痛效果

The effect of fentanyl for analgesia on brachial plexus block

目的观察芬太尼用于臂丛神经阻滞的镇痛效果。方法将50例美国麻醉医师协会Ⅰ～Ⅱ级上肢手术需要臂丛神经阻滞的患者，按随机数字表随机分为试验组和对照组，各25例。试验组采用0.25%罗哌卡因＋1%利多卡因25 ml＋芬太尼0.1 mg对照组采用0.25%罗哌卡因＋1%利多卡因25 ml进行臂丛神经阻滞麻醉。比较2组手术开始切皮时及术后2、6、12 h视觉模拟疼痛评分、麻醉起效时间、持续时间。结果试验组感觉神经阻滞起效时间明显短于对照组[（3.20±0.25）min比（4.50±0.97）min]，镇痛持续时间明显长于对照组[（9.2±1.6）min比（5.1±1.2）min] ，术后2、6、12 h 视觉模拟疼痛评分低于对照组[（4.12±1.24）分比（5.63±1.23）分，（5.27±2.14）分比（7.34±1.42）分，（6.34±2.23）分比（8.35±2.15）分] （均P＜0.05）。结论芬太尼应用于臂丛神经阻滞可缩短阻滞起效时间，延长镇痛时间。

ObjectiveTo observe the effect of fentanyl for analgesia on brachial plexus block. MethodsFifty patients with American Society of Anesthesiologists （ASA） grade ⅠⅡ upper limb operation with brachial plexus nerve block anesthesia were randomly divided into experimental group and control group; each group had 25 cases. Experimental group was given 0.25% ropivacaine ＋1%lidocaine 25 ml ＋ fentanyl 0.1 mg for brachial plexus block. Control group was given 0.25% ropivacaine＋1% lidocaine 25 ml. Visual analogue scale （VAS） pain score at the operation incision at the start, 2, 6 and 12 h after operation was observed; onset time and duration of anesthesia were recorded. ResultsSensory and motor block onset time in experimental group was shorter than that in control group[（3.20±0.25）min vs （4.50±0.97）min] （P〈0.05）; duration of analgesia was significantly longer than that in control group [（9.2±1.6）min vs （5.1±1.2）min] （P〈0.05）. VAS pain score was lower at 2, 6, 12 h after operation, compared with those in control group[（4.12±1.24）scores vs （5.63±1.23）scores,（5.27±2.14）scores vs （7.34±1.42）scores,（6.34±2.23）scores vs （8.35±2.15）scores]（all P〈0.05）. ConclusionFentanyl in brachial plexus block can shorten the block onset time and prolong the duration of analgesia.