低浓度罗哌卡因联合舒芬太尼用于上肢手术的麻醉效果和安全性观察

Clinical Observation of Low-dose Ropivacaine Combined with Sufentanil in Upper Limb Anesthesia

目的：观察低浓度罗哌卡因联合舒芬太尼用于上肢手术的麻醉效果和安全性。方法：100例行上肢手术患者随机均分为对照组和试验组。对照组患者静脉注射0.5%罗哌卡因20 ml;试验组患者给予0.375%罗哌卡因20 ml＋舒芬太尼10μg混合,静脉注射。观察两组患者的麻醉效果,疼痛消失时间、镇痛持续时间,麻醉前（T0）及麻醉阻滞后5 min（T1）、15 min（T2）、30 min（T3）和术后4 h（T4）、8 h（T5）时的疼痛视觉模拟（VAS）评分及不良反应发生情况。结果：试验组患者T1-T5时、对照组患者T2-T4时VAS评分均显著低于同组T0时,且T1、T2、T5时试验组低于对照组,差异均有统计学意义（P〈0.05）。试验组患者麻醉总有效率显著高于对照组,疼痛消失时间显著短于对照组,镇痛持续时间显著长于对照组,不良反应发生率显著低于对照组,差异均有统计学意义（P〈0.05）。结论：低浓度罗哌卡因联合舒芬太尼用于上肢手术的麻醉效果和安全性均较好。

OBJECTIVE ： To observe the efficacy and safety of low-dose ropivacaine combined with sufentanil in the upper limb anesthesia. METHODS： 100 patients with upper limb anesthesia were randomly divided into control group and test group. Control group was intravenously injected 20 ml 0.5% ropivacaine; test group was intravenously injected 20 ml 0.375% ropivacaine ＋10 μg sufentanil. The anesthesia effect, disappearance time of pain, duration of analgesia, and pain visual analogue （VAS） score before anesthesia （T0）, 5 min （T1）, 15 min （T2） and 30 min （T3） after anesthetic block, and 4 h （T4） and 8 h （T5） after surgery, and incidence of adverse reactions in 2 groups were observed. RESULTS： VAS scores at T1-T5 in test group and T2-T4 in control group were significantly lower than To, test group was lower than control group at T1, T2 and T5, the differences were statistically significant （P〈0.05）. The total effective rate of anesthesia in test group was significantly higher than control group, disappearance time of pain was significantly shorter than control group, duration of analgesia was significantly longer than control group, incidence of adverse reactions was significantly lower than control group, the differences were statistically significant （P〈0.05）. CONCLUSIONS： Both the efficacy and safety of low-dose ropivacaine combined with sufentanil in the upper limb anesthesia are good.