超声引导下地佐辛联合局麻药对臂丛神经阻滞麻醉的影响

Effect of Dezocine Combined Local Anaesthesia under Ultrasound Guidance on Brachial Plexus Block Anesthesia

目的观察地佐辛联合罗哌卡因、利多卡因对臂丛神经阻滞麻醉的影响。方法选取苏州市相城人民医院2017年12月至2018年12月收治的行上肢手术的患者80例,随机分为对照组及观察组,每组40例。所有患者均采用斜角肌间隙入路法行臂丛神经阻滞治疗,后对照组患者注入含罗哌卡因及利多卡因稀释的生理盐水,观察组患者注入地佐辛、罗哌卡因、利多卡因稀释的生理盐水。比较两组患者感觉阻滞起效时间、痛觉完全消失时间、运动阻滞起效时间、运动阻滞持续时间、镇痛持续时间及视觉模拟评分(VAS)。结果观察组患者的感觉阻滞起效时间、痛觉消失时间以及运动阻滞起效时间明显短于对照组患者,观察组运动阻滞持续时间及镇痛持续时间较对照组更长,差异有统计学意义(P<0.05)。观察组患者VAS评分明显低于对照组患者(P<0.05)。结论通过地佐辛联合罗哌卡因、利多卡因进行臂丛神经阻滞治疗,可以减少运动阻滞的作用时间,强化镇痛效果。

Objective To analyze the effect of combination of dezocine,ropivacaine and lidocaine on brachial plexus block anesthesia.Methods Eighty patients for upper extremity surgery were selected from December 2017 to December 2018 in Suzhou Xiangcheng People's Hospital.They were randomly divided into control group and observation group,40 per group.All patients received scalenus muscle space approach to perform brachial plexus block.Then the control group was injected with saline diluted with ropivacaine and lidocaine,the observation group was injected with saline diluted with dezocine,ropivacaine and lidocaine.The onset time of sensory block,the time of complete disappearance of pain,the onset time of motor block,the duration of motor block,the duration of analgesia and visual analogue scale(VAS)were compared between the two groups.Results The onset time of sensory block,the time of pain disappearance and the onset time of motor block in the observation group were significantly shorter than those in the control group,and the duration of motor block and analgesia were longer than those in the control group,with statistically significant differences(P<0.05).The VAS scores of patients in the observation group were significantly lower than those in the control group(P<0.05).Conclusion The brachial plexus block using the combination of dezocine,ropivacaine and lidocaine can reduce the action time of motor block,and strengthen the analgesic effect.