不同浓度甲磺酸罗哌卡因颈丛神经阻滞的临床效果

Efficacy of different concentration of ropivacaine mesylate in cervical plexus block

目的 比较不同浓度甲磺酸罗哌卡因实施颈丛神经阻滞的效果. 方法 选择美国麻醉医师协会（ASA）分级Ⅰ～Ⅱ级甲状腺腺瘤患者80例,采用随机数字表法将患者随机分成A、B、C、D4组,每组20例,依次采用0.55％、0.45％、0.35％、0.25％甲磺酸罗哌卡因实施颈丛神经阻滞,观察各组患者麻醉后的镇痛效果及呼吸和心率（heart rate,HR）的变化.结果 A、B、C、D组镇痛效果的平均秩次依次为27、26、26、15,A、B、C组的镇痛效果明显高于D组（P＜0.05）,A、B、C组之间差异无统计学意义（P＞0.05）.A、B、C、D组呼吸困难程度的平均秩次依次为16、38、39、67,A组呼吸困难程度明显高于B、C、D组（P＜0.05）.A、B、C、D组HR增加的平均秩次依次为20、39、39、62,A组HR增加明显高于B、C、D组（P＜0.05）. 结论 0.35％～0.45％甲磺酸罗哌卡因是颈丛神经阻滞较为合适的局麻药浓度.

Objective To compare the efficacy of different concentration of ropivacaine mesylate in cervical plexus nerve block.Methods Eighty ASA Ⅰ-Ⅱ thyroid adenoma patients were randomly divided into four groups：group A,group B,group C and group D （n=20）,which were respectively performed cervical plexus nerve block with 0.55%,0.45%,0.35%,0.25% Ropivacaine Mesylate.The analgesic effect and changes of breathing rate and heart rate （HR） were observed.Results Compared with group D（15）,the mean rank of analgesic effect in group A,group B and group C（27,26,26） was significantly higher（P〈0.05）.The mean rank of difficulty breathing in group B,group C and group D （38,39,67） were higher than that in group A（16） （P〈0.05）.The mean rank of increased HR in group B,group C and group D（39,39,62） were higher than that in group A（20）（P〈0.05）.Conclusions 0.35%-0.45% ropivacaine mesylate is appropriate concentration in cervical plexus nerve block.