探讨超声引导下肌间沟臂丛神经阻滞的麻醉效果

The Anesthetic Effect of Ultrasound Guided Intermuscular Brachial Plexus Block

目的研究分析超声引导肌间沟臂丛神经阻滞的麻醉使用不同浓度的罗哌卡因临床情况。方法选取我院接收的上肢手术患者180例作为研究对象,将其分为低浓度组、中浓度组、高浓度组,每组均为60例。三组使用中低高三种浓度的罗哌卡因麻醉,对三组的阻滞情况,麻醉时间等进行比较分析。结果高浓度组患者的肌皮神经阻滞率为100.0%,桡神经为100.0%,尺神经为81.7%,中浓度组分别为93.3%、91.7%、71.7%,低浓度组分别为85.0%、86.7%及61.7%,三组的神经阻滞情况对比,差异具有统计学意义(P<0.05)。不同浓度的罗哌卡因麻醉患者的麻醉生效时间、持续时间、阻滞恢复时间对比,差异具有统计学意义(P<0.05)。结论在0.3%～0.5%之间的浓度,随着罗哌卡因的浓度增加,阻滞效果也会提升,镇痛持续时间越长,术后恢复时间也会增加。

Objective To study and analyze the clinical situation of ropivacaine with different concentrations of anesthesia guided by ultrasound guided intermuscular brachial plexus block. Methods 180 cases of upper limb surgery received by our hospital were selected as the research objects. They were divided into low concentration group, medium concentration group and high concentration group, 60 cases in each group. The three groups were anesthetized with ropivacaine with medium low concentration and high concentration. The block condition and anesthetic time of the three groups were compared and analyzed. Results In the high concentration group, the musculocutaneous nerve block rate was 100.0%, the radial nerve was 100.0%, and the ulnar nerve was 81.7%. The medium concentration group was 93.3%, 91.7% and 71.7% respectively. The low concentration group was 85.0%, 86.7% and 61.7% respectively. The difference of nerve block between the three groups was statistically significant（P 〈0.05）. The effective time, duration and block recovery time of anesthetic patients with different concentrations of ropivacaine were statistically different（P〈 0.05）. Conclusion The concentration between 0.3% and 0.5% increased with the increase of ropivacaine, and the longer the duration of the analgesia, the recovery time was also increased.