比较不同浓度罗哌卡因用于超声引导下肌间沟臂丛神经阻滞的麻醉效果

Comparison of Anesthetic Effect of Different Concentrations of Ropivacaine in the Ultrasound-guided Iinterscalene Brachial Plexus Block

目的探讨不同浓度罗哌卡因用于超声引导下肌间沟臂丛神经阻滞的麻醉效果。方法方便选取2015年1月—2016年12月期间该院收治的上肢手术患者180例作为研究对象,随机分为低浓度组、中浓度组以及高浓度组,每组60例,分别给予低浓度、中浓度及高浓度罗哌卡因,观察并对比3组患者不同部位神经完全阻滞效果、麻醉起效时间、镇痛持续时间以及运动阻滞恢复时间等。结果高浓度组患者肌皮神经(100.0%)、桡神经(100.0%)以及尺神经(81.7%)完全阻滞率明显高于中浓度组(93.3%、91.7%及71.7%),中浓度组患者肌皮神经(93.3%)、桡神经(91.7%)、正中神经(91.7%)以及尺神经(71.7%)完全阻滞率明显高于低浓度组(85.0%、86.7%、83.3%及61.7%),差异有统计学意义(P<0.05)。不同浓度组患者的麻醉起效时间、镇痛持续时间以及运动阻滞恢复时间比较,差异有统计学意义(P<0.05)。结论罗哌卡因在0.3%~0.5%区间内浓度越高,神经阻滞效果越好,起效越快,镇痛持续越长,但术后恢复时间也随之增加。

Objective To observe the anesthetic effect of different concentrations of ropivacaine in the ultrasound-guided interscalene brachial plexus block. Methods Convenient selection 180 cases of patients with upper limb operation admitted and treated in our hospital from January 2015 to December 2016 were selected as the research objects and randomly divided into three groups with 60 cases in each, and the complete nerve block effect of different parts, anesthetic onset time,analgesia duration and motor block recovery time of the three groups were observed and compared. Results The complete block rate of musculocutaneus nerve, radial nerve and ulnar nerve in the high concentration group was obviously higher than that in the moderate concentration group（100.0%, 100.0%, 81.7% vs 93.3%, 91.7%, 71.7%）, and the complete block rate of musculocutaneus nerve, radial nerve, median nerve and ulnar nerve in the moderate concentration group was obviously higher than that in the lower concentration group（93.3%, 91.7%, 91.7%, 71.7% vs 85.0%,86.7%,83.3%, 61.7%）, and the differences were statistically significant（P〈0.05）, and the differences in the anesthetic onset time, analgesia duration and motor block recovery tome between different concentrations groups were statistically significant by comparison（P〈0.05）. Conclusion The higher the concentration of ropivacaine between 0.3% and 0.5%, the better the nerve block effect, the faster the working time and the longer the analgesia duration, but the recovery time after operation also increases.