B超定位下低浓度罗哌卡因臂丛神经阻滞在上肢手术中的可行性研究

The feasibility study on brachial plexus block in the operation of upper limb with low concentration of ropivacaine under B ultrasound localization

目的探讨上肢手术中进行B超定位下低浓度罗哌卡因臂丛神经阻滞的可行性。方法入选2013年4月~2014年4月本院行上肢手术的患者90例,按麻醉方式分为实验组、对照组,每组45例。实验组进行低浓度罗哌卡因臂丛神经阻滞,对照组进行常规配制浓度罗哌卡因臂丛神经阻滞,比较两组患者的恢复运动时间、麻醉持续镇痛时间、镇痛起效时间等,臂丛神经阻滞优良率,麻醉后不良反应发生率。结果实验组的恢复运动时间显著短于对照组,差异有统计学意义（P〈0.05）,麻醉持续镇痛时间、镇痛起效时间与对照组比较,差异无统计学意义（P〉0.05）;实验组、对照组的臂丛神经阻滞优良率分别为88.9%、93.3%,两组比较,差异无统计学意义（P〉0.05）;实验组、对照组的麻醉后不良反应发生率分别为4.4%、24.5%,两组比较,差异有统计学意义（P〈0.05）。结论上肢手术患者在B超定位下行低浓度罗哌卡因臂丛神经阻滞,效果确切,术后不良反应少,值得临床推广。

Objective To study the feasibility of brachial plexus block in the operation of upper limb with low concentration of ropivacaine under B ultrasound localization. Methods 90 cases with upper limb operation were selected in our hospital from April 2013 to April 2014,and they were divided into experimental group（n=45） and control group（n=45） according to anesthesia way, the experimental group was given low concentration of ropivacaine in brachial plexus block,the control group was given routine preparation concentration of ropivacaine in brachial plexus block,movement recovery time,anesthesia cotinuous analgesia time,and analgesic onset time and so on,excellent and good rate of brachial plexus block,and the incidence rate of adverse reaction after anesthesia of between two groups were compared. Results The restoration movement time of experimental group was significantly shorter than control group（P 0.05）,and there was no statistical difference of anesthesia cotinuous analgesia time,analgesic onset time between two groups（P〈0.05）.The excellent and good rate brachial plexus block in experimental group and the control group was 88.9% and 93.3%respectively,and there was no statistical differencebetween two groups（P 0.05）;after anesthesia,incidence rate of adverse reaction of experimental group and the control group was 4.4% and 24.5% respectively,and there was a statistical differencebetween two groups（P〈0.05）. Conclusion The patients with upper limb surgery given brachial plexus block with low concentration of ropivacaine under B ultrasound localization has an exact effect,which have few postoperative adverse reaction,it is worthy of clinical promotion.