探讨罗哌卡因复合利多卡因在臂丛神经麻醉中的临床应用效果

Investigation on the Clinical Application of Ropivacaine Combined with Lidocaine in Brachial Plexus Anesthesia

目的探讨罗哌卡因复合利多卡因在臂丛神经麻醉中的临床应用效果。方法2018年2月—2019年2月方便选取该院收治手术患者156例,按照奇偶数法将156例患者分为两组,两组均行臂丛神经麻醉,对照组应用利多卡因+生理盐水复合麻醉,观察组应用罗哌卡因+利多卡因复合麻醉,对比两组手术患者的运动、感觉阻滞起效时间、麻醉维持时间、各时间段平均动脉压、麻醉不良反应、术后各个时间段的疼痛评分。结果两组手术患者的麻醉起效时间对比差异无统计学意义[(运动、感觉阻滞起效时间:(10.6±2.7)min vs(10.2±3.0)min,(14.5±6.0)min vs(14.2±5.8)min(t=0.338,0.717,P>0.05)];观察组手术患者的麻醉维持时间比对照组长[运动、感觉阻滞维持时间:(7.8±0.6)h vs(5.0±0.5)h,(9.8±1.3)h vs(6.3±1.2)h(t=11.882,18.776,P<0.05);观察组术后切皮前、切皮5 min的平均动脉压小于对照组(P<0.05),观察组切皮10 min的平均动脉压大于对照组(P<0.05)],观察组切皮60 min与切皮90 min的平均动脉压与对照组比较差异无统计学意义(P>0.05);观察组手术患者术后不良反应少于对照组(11.54%vs 24.36%)(χ^2=13.298,P<0.05);观察组术后各个时间段的疼痛评分低于对照组(P<0.05)。结论罗哌卡因复合利多卡因在臂丛神经麻醉中的效果显著,麻醉效果维持时间长,不良反应少,舒适度高。

Objective To investigate the clinical application of ropivacaine combined with lidocaine in brachial plexus anesthesia.Methods From February 2018 to February 2019,convenient selected 156 patients underwent surgery in the hospital.156 patients were divided into two groups according to the odd-even method.Both groups underwent brachial plexus anesthesia,and the control group received lidocaine+physiology.Combined anesthesia with saline,the observation group was treated with ropivacaine+lidocaine combined anesthesia.The exercise,sensory block onset time,anesthesia maintenance time,mean arterial pressure at various time points,anesthetic adverse reactions,postoperative pain scores for each time period.Results There was no statistically significant difference in the onset time of anesthesia between the two groups[sports,sensory block onset time:(10.6±2.7)min vs(10.2±3.0)min,(14.5±6.0)min vs(14.2±5.8)min(t=0.338,0.717,P>0.05)];The anesthesia maintenance time of the observation group was longer than that of the control group(sports,sensory block maintenance time:(7.8±0.6)h vs(5.0±0.5)h,(9.8±1.3)h vs(6.3±1.2)h(t=11.882,18.776,P<0.05);The average arterial pressure of the observation group before and afte 5 minr the incision was less than that of the control group(P<0.05).The average arterial pressure of the observation group was greater than that of the control group for 10 min(P<0.05).There was no statistically significant difference in the mean arterial pressure between the skin and the skin for 90 min compared with the control group(P>0.05).The postoperative adverse reactions in the observation group were less than those in the control group(11.54%vs 24.36%)(χ^2=13.298,P<0.05);The pain score of the observation group at each time period was lower than that of the control group(P<0.05).Conclusion Ropivacaine combined with lidocaine has significant effects in brachial plexus anesthesia.The anesthetic effect lasts for a long time,with less adverse reactions and high comfort.