不同浓度盐酸罗哌卡因用于下肢神经阻滞麻醉效果探讨

Effects of different concentrations of ropivacaine hydrochloride on lower limb nerve block anesthesia

目的 探讨浓度为0.25%、0.375%、0.5%的盐酸罗哌卡因用于下肢神经阻滞麻醉的临床效果.方法 选取宁波市镇海区中医医院麻醉科于2014年9月-2015年2月收治的75例进行下肢神经阻滞麻醉的患者作为本次研究过程中的研究对象,将他们分成等量人数的3组：0.25%组、0.375%组、0.5%组,并对3组患者分别使用浓度为0.25%、0.375%、0.5%的盐酸罗哌卡进行下肢神经阻滞麻醉;对3组对象的临床资料进行回顾性分析,观察3组患者进行下肢神经阻滞麻醉后的效果.结果 分析可得,0.25%组25例患者中运动阻滞时间为（36.8±5.9）min,运动阻滞为7例患者,发生神经阻滞的患者为11例.0.375%组25例患者中运动阻滞时间为（23.1±4.3）min,运动阻滞为14例患者,发生神经阻滞的患者为18例.0.5%组25例患者中运动阻滞时间为（20.6±5.7）min,运动阻滞为16例患者,发生神经阻滞的患者为18例.可得,0.375%组的阻滞时间大于0.5%组,小于0.25%组;0.375%组的运动阻滞率为56.0%,高于0.25%组,低于0.5%组;0.375%组和0.5%组的神经阻滞率相同,高于0.25%组,差异均具有统计学意义（P〈0.05）.结论 使用浓度为0.375%的盐酸罗哌卡的麻醉效果相对较好,既可减少麻醉药物的用量,又可以保障麻醉效果,满足临床的实际需求,值得将该方法加以推广应用.

Objective To investigate the clinical effect of ropivacaine hydrochloride at 0.25%, 0.375% and 0.5% concentration for lower limb nerve block anesthesia.Methods75 cases of lower extremity nerve block anesthesia from Ningbo Zhenhai District Hospital of traditional Chinese Medicine from September 2014 to February 2015 were enrolled in the course of the study, they were divided into three groups： group 0.25%, the equivalent number of 0.375% and 0.5% groups, and three groups of patients were made with a concentration of 0.25%, 0.375%, 0.5% ropivacaine hydrochloride for lower extremity nerve block anesthesia;the clinical data of three groups were analyzed retrospectively, observation of three groups of patients with lower limb nerve block effect.ResultsThe results showed that 0.25% groups of patients in the motor block time was （36.8±5.9） minutes, motor block in patients with a total of 7 cases, with nerve block in patients with a total of 11 cases.0.375% groups of patients in the motor block time was （23.1±4.3） minutes, motor block in patients with a total of 14 cases, with nerve block in patients with a total of 18 cases.0.5% groups of patients in the motor block time was （20.6±5.7） minutes, motor block in patients with a total of 16 cases, with nerve block in patients with a total of 18 cases.Available block time of 0.375% groups of more than 0.5% groups, less than 0.25% groups;0.375% motor block group was 56.0%, higher than the 0.25% group, lower than the 0.5% group;the 0.375% group and 0.5% group of nerve block ratio is same, higher than the 0.25% group, the difference was statistically significant （P〈0.05）.ConclusionThe effect of anesthesia using concentration of 0.375% ropivacaine hydrochloride is relatively good, can reduce the dosage of anesthetic drugs, but also ensure the anesthetic effect, meet the clinical requirement, this method will be applied to.