地塞米松作为罗哌卡因佐剂用于超声引导下锁骨上臂丛神经阻滞中的效果

Effects of Dexamethasone as Ropivacaine Adjuvant in Ultrasound-Guided Supraclavicular Brachial Plexus Block

目的探讨地塞米松作为罗哌卡因佐剂用于超声引导下锁骨上臂丛神经阻滞中的效果。方法选择2018年10月至2020年10月在揭阳市慈云医院行单侧上肢手术的患者60例,采用随机数字表法分为试验组和对照组,每组30例。两组均实施超声引导下锁骨上臂丛神经阻滞,试验组使用药物为加入地塞米松5 mg的0.375%罗哌卡因30 ml,对照组使用药物为0.375%罗哌卡因30 ml,两组术后均不使用静脉自控镇痛,记录两组感觉及运动阻滞起效时间、感觉及运动阻滞持续时间、术后氟比洛芬酯及地佐辛使用率、术后48 h内阻滞相关不良反应发生情况。结果与对照组比较,试验组感觉及运动阻滞起效时间均较短,感觉及运动阻滞持续时间均较长,术后氟比洛芬酯使用率较低,差异有统计学意义(P<0.05);两组术后地佐辛使用率比较,差异无统计学意义(P>0.05);两组术后48 h内均未发生阻滞相关不良反应。结论地塞米松作为罗哌卡因佐剂用于超声引导下锁骨上臂丛神经阻滞中的效果显著,能够缩短阻滞起效时间,延长阻滞持续时间,减少术后镇痛药物的应用。

Objective The effects of dexamethasone as ropivacaine adjuvant in ultrasound-guided supraclavicular brachial plexus block were investigated.Methods From October 2018 to October 2020,60 patients who underwent unilateral upper limb surgery in Jieyang Ciyun Hospital were selected.They were divided into an experiment group and a control group according to the random number table method,with 30 cases in each.Both groups were given ultrasound-guided supraclavicular brachial plexus block.Patients in the experiment group were treated with 30 ml 0.375%ropivacaine added with 5 mg dexamethasone,while 30 ml 0.375%ropivacaine was used in the control group.Patients in both groups did not use patient-controlled intravenous analgesia.The onset time of sensory and motion block,duration of sensory and motion block,the usage of flurbiprofen axetil and dezocine after operation and the incidence of adverse reactions related to block within 48 hours after operation were recorded.Results Compared with the control group,the onset time of sensory and motion block in the experiment group were significantly shorter(P<0.05),the duration of sensory and motion block were significantly prolonged(P<0.05)and the usage rate of flurbiprofen axetil after operation was significantly lower(P<0.05).There was no significant difference in the usage rate of dezocine after operation between the two groups(P>0.05).No adverse reactions related to block occurred in both groups within 48 hours after operation.Conclusion The effects of dexamethasone as ropivacaine adjuvant in ultrasound-guided supraclavicular brachial plexus block were obvious,with the onset time of block shorten,the duration of block prolonged and the usage of postoperative analgesic drugs reduced.