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

Anesthetic Effects of Different Concentration of Ropivacaine for Ultrasound-guided Intermuscular Sulcus 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:选取2017年6月至2018年2月漳州市第三医院收治的拟行上肢手术的患者82例,采用随机数字表法分为A组和B组,每组41例。两组患者均在超声引导下实施肌间沟臂丛神经阻滞麻醉,麻醉药物选用罗哌卡因。其中A组患者给予0.3%罗哌卡因,B组患者给予0.4%罗哌卡因。观察两组患者的麻醉效果、麻醉阻滞起效时间及并发症发生情况。结果:A组患者的麻醉效果良好率为92.68%(38/41),明显高于B组的82.93%(34/41),差异有统计学意义(P<0.05);A组患者桡神经、尺神经、正中神经和肌皮神经的麻醉阻滞起效时间明显短于B组,差异有统计学意义(P<0.05);A组患者并发症发生率为9.76%(4/41),明显低于B组的26.83%(11/41),差异有统计学意义(P<0.05)。结论:小剂量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显著,镇痛效果理想,术后并发症少。

OBJECTIVE： To probe into the anesthetic effects different concentration of ropivacaine for ultrasoundguided intermuscular sulcus brachial plexus block. METHODS： 82 patients undergoing upper extremity surgery admitted into Ganzhou the Third Hospital from Jun. 2017 to Feb. 2018 were extracted to be divided into group A and group B via the random number table,with 41 cases in each. Two groups of patients were treated with ultrasoundguided intermuscular sulcus brachial plexus block,and the anaesthetic drug was ropivacaine. Meanwhile,patients in group A were given 0. 3% ropivacaine,while group B received 0. 4% ropivacaine. The anesthetic effects,onset time of anesthesia block and complications of two groups were observed. RESULTS： The good rate of anesthetic effects in group A was 92. 68%（ 38/41）,significantly higher than that in group B [82. 93%（ 34/41） ],with statistically significant difference（ P〈0. 05）. The onset time of anesthesia block for radial nerve,ulnar nerve,median nerve and musculocutaneous nerve in group A were significantly shorter than those in group B,with statistically significant difference（ P〈0. 05）. The incidence of adverse drug reactions of group A was 9. 76%（ 4/41）,significantly lower than that of group B [26. 83%（ 11/41） ],with statistically significant difference（ P〈0. 05）. CONCLUSIONS： The anesthetic effects of low-dose ropivacaine for ultrasound-guided intermuscular sulcus brachial plexus block is significant,with ideal analgesic effects and less postoperative complications.