罗哌卡因复合甲泼尼龙对臂丛神经阻滞的影响

Effects of Ropivacaine combined with Methylprednisolone on brachial plexus block

目的探讨罗哌卡因复合甲泼尼龙对臂丛神经阻滞效果的影响及其安全性。方法选取2015年6月~2016年5月于我院行肩部以下手术需行肌间沟臂丛神经阻滞患者200例,根据随机数字表法将患者分为观察组(0.33%罗哌卡因30 ml+甲泼尼龙40 mg)和对照组(0.33%罗哌卡因30 ml),每组100例,两组均以神经刺激仪引导行肌间沟臂丛神经阻滞。比较两组患者注药后感觉和运动阻滞起效和持续时间以及并发症发生情况。结果观察组感觉和运动阻滞起效时间分别为(10.2±3.8)、(13.7±3.9)min,较对照组缩短[(14.4±3.1)、(18.1±3.4)min](P<0.05);观察组感觉阻滞持续时间与运动阻滞持续时间分别为(825.2±61.3)、(733.5±77.1)min,较对照组延长[(691.3±56.3)、(566.9±78.3)min](P<0.05);观察组发生2例心动过缓,不良反应发生率为2.0%,对照组出现4例心动过缓、4例头晕,不良反应发生率为8.0%,观察组较对照组低(P<0.05)。结论罗哌卡因复合甲泼尼龙能显著缩短臂丛神经感觉、运动阻滞起效时间,延长持续时间,神经阻滞效果好,且有较高的安全性。

Objective To explore the effects and safety of brachial plexus block（BPB） with Ropivacaine combined with Methylprednisolone.Methods 200 patients undergoing operation below shoulder level in our hospital from June 2015 to May 2016 were randomly divide into observation group（0.33% Ropivacaine 30 ml ＋Methylprednisolone 40 mg） and control group（0.33% Ropivacaine 30 ml） with 100 cases in each group according to the random number table method,two groups were guided to the BPB by the nerve stimulator.The sensory and motor block onset time,duration time of anesthesia,and complications were compared.Results Sensory and motor block onset time of the observation group was（10.2±3.8）,（13.7±3.9） min,shorter than that of the control group [（14.4 ±3.1）,（18.1±3.4）min]（P〈0.05）;duration time of sensory block and motor block of the observation group was（825.2±61.3）,（733.5±77.1） min respectively,longer than that of the control group [（691.3±56.3）,（566.9±78.3） min]（P〈0.05）;the observation group had 2 cases of bradycardia,the control group was obsererved 4 cases of bradycardia and 4 cases of dizziness,the incidence of adverse reaction of the observation group（2.0%） was lower than that of the control group（8.0%）（P〈0.05）.Conclusion Ropivacaine combined with Methylprednisolone for BPB shortens the sensory and motor block onset time,prolongs the duration time of anesthesia,and improves the safety of anesthesia.