不同容量局部麻醉药用于超声引导锁骨下臂丛神经阻滞的效果比较

Comparison the efficacy of different volume of local anesthetics for ultrasound-guided infraclavicular brachial block

目的比较不同容量罗哌卡因与利多卡因混合液用于超声引导锁骨下臂丛神经阻滞的效果。方法60例择期行上肢手术的患者按随机数字表法分为A、B两组，每组30例，分别应用0．3％罗哌卡因和1％利多卡因混合液20ml和30ml实施超声引导锁骨下臂丛神经阻滞。阻滞完成后每隔5min测定臂丛各分支的感觉阻滞效果，30min后测定臂丛各分支的运动阻滞程度。记录感觉阻滞起效时间、外科麻醉成功率、并发症及麻醉维持时间。结果A、B组的外科麻醉成功率[93．3％（28／30）比96．7％（29／30），P〉0．05]、感觉阻滞起效时间[10（5）min比5（5）min，P〉0．05]、运动阻滞程度差异无统计学意义，A组的麻醉维持时间比B组短（P〈0．05）。结论0．3％罗哌卡因与1％利多卡因混合液20ml及30ml用于超声引导锁骨下臂丛神经阻滞具有相似的麻醉成功率和起效时间。

Objective To compare the efficacy of different volume of ropivacaine and lidocaine for ultrasound-guided infraclavicular brachial block. Methods Sixty patients scheduled for distal upper limb surgery were divided into group A and group B by random digits table method with 30 cases each. The patients were given ultrasound-guided infraclavicular brachial block, but the patients in group A using 0.3% ropivacaine mixed with 1% lidocaine 20 ml,the patients in group B using the same mixture 30 ml. Sensory block was assessed every 5 min after the block. Motor block was evaluated at 30 min after the block. The onset time of anesthesia,surgical success rate,complications and duration of anesthesia were recorded. Results There was no significant difference in the surgical success rate [93.3%（28/30） vs. 96.7%（29/30）, P 〉 0.05 ], onset time of sensory block [ 10 （5） min vs. 5 （ 5 ） min,P 〉 0.05 ] and degree of motor block between the 2 groups. The duration of anesthesia in group A was shorter than that in group B （P 〈 0.05）. Conclusion The efficacy of ultrasoundguided infraclavicular brachial block with the mixture of 0.3% ropivaealne and 1% lidocaine 20 ml and 30 ml is similar in surgical success rate and onset time of anesthesia.