不同浓度盐酸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 Effect of Different Concentrations of Ropivacaine for Ultrasoundguided Intermuscular Groove Brachial Plexus Block

目的探讨不同浓度盐酸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。方法研究对象共方便选择2018年11月-2019年11月期间在该院行超声引导下肌间沟臂丛神经阻滞的患者114例,根据盐酸罗哌卡因的浓度分成3组,包括0.3%组(例数=38,患者应用浓度为0.3%的盐酸罗哌卡因)、0.4%组(例数=38,患者应用浓度为0.4%的盐酸罗哌卡因)和0.5%组(例数=38,患者应用浓度为0.5%的盐酸罗哌卡因)。结果患者的肌皮神经完全阻滞率,从高到低依次为0.5%组、0.4%组、0.3%组,比较差异有统计学意义(χ~2=12.636,P<0.05);患者的桡神经完全阻滞率,从高到低依次为0.5%组、0.4%组、0.3%组,差异有统计学意义(χ~2=14.353,P<0.05);患者的正中神经完全阻滞率,从高到低依次为0.5%组、0.4%组、0.3%组,差异有统计学意义(χ~2=14.353,P<0.05);患者的尺神经完全阻滞率,从高到低依次为0.5%组、0.4%组、0.3%组,差异有统计学意义(χ~2=10.538,P<0.05)。患者的麻醉起效时间,从短到长依次为0.5%组、0.4%组、0.3%组,差异有统计学意义(t=7.638,P<0.05);患者的镇痛持续时间,从长到短依次为0.5%组、0.4%组、0.3%组,差异有统计学意义(t=8.046,P<0.05);患者的运动阻滞恢复时间,从长到短依次为0.5%组、0.4%组、0.3%组,差异有统计学意义(t=8.859,P<0.05)。结论对于行超声引导下肌间沟臂丛神经阻滞的患者来说,浓度为0.5%的盐酸罗哌卡因具有明显的应用优势,可获得非常理想的肌皮神经、桡神经、正中神经和尺神经完全阻滞率,同时能够具有较短的麻醉起效时间和较长的镇痛持续时间,虽然其运动阻滞恢复时间也随之延长,但总体麻醉效果良好,值得推荐临床应用。

Objective To investigate the anesthetic effect of different concentrations of ropivacaine for ultrasound-guided intermuscular groove brachial plexus block. Methods Convenient selected 114 patients with ultrasound-guided intermuscular sulcus brachial plexus block in the hospital from November 20189 to November 2019 were divided into three groups according,including 0.3% group(cases=38, patients used 0.3% ropivacaine), 0.4% group(cases=38, patients used 0.4% ropivacaine) and 0.5% group(cases=38, patients used 0.5% ropivacaine). Results The complete myocutaneous nerve block rate was 0.5%, 0.4% and 0.3% respectively from high to low,and the difference was statistically significant(χ~2=12.636, P<0.05);the complete radial nerve block rate of patients was 0.5%, 0.4% and 0.3% respectively from high to low,and the difference was statistically significant(χ~2=14.353, P<0.05);and the complete median nerve block rate of patients was from high to low,and the difference was statistically significant(χ~2=14.353, P<0.05).the complete ulnar nerve block rate of patients was 0.5%,0.4% and 0.3% respectively from high to low,and the difference was statistically significant(χ~2=10.538, P<0.05). The onset time of anesthesia in patients was 0.5%, 0.4% and 0.3% from short to long,and the difference was statistically significant(t=7.638, P<0.05);the duration of analgesia in patients was 0.5%, 0.4% and 0.3% respectively from long to short,and the difference was statistically significant(t =8.046, P <0.05);There were significant differences between 0.4% group and 0.3%group,and the difference was statistically significant(t=8.859, P<0.05). Conclusion Ropivacaine with 0.5% concentration has good complete blockade rates of musculocutaneous nerve, radial nerve, median nerve and ulnar nerve. It has shorter onset time and longer analgesic duration. However, the overall anesthetic effect is good and it is worth clinical application.