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

Anesthesia effect of different concentrations of ropivacaine for ultrasound-guided brachial plexus block in the intermuscular groove

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2019年7月至2020年7月于本院行上肢手术治疗的90例患者作为研究对象,按照随机数字表法分为两组,每组45例。对照组予以0.3%罗哌卡因皮下注射,观察组予以0.5%罗哌卡因皮下注射,比较两组麻醉效果和麻醉前后血清肌钙蛋白Ⅰ(CTnⅠ)、肌酸激酶同工酶(CK-MB)水平、收缩压(SBP)水平及麻醉时间指标、痛觉阻滞率、不良反应发生情况。结果观察组麻醉优良率为97.78%,高于对照组的82.22%,差异有统计学意义(P<0.05)。麻醉后,观察组SBP水平低于对照组,CTnⅠ、CK-MB水平均高于对照组,差异有统计学意义(P<0.05)。观察组正中神经、尺神经、桡神经、肌皮神经痛觉总阻滞率均高于对照组,差异有统计学意义(P<0.05)。观察组麻醉起效时间短于对照组,镇痛持续时间、运动功能恢复时间均长于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论与0.3%罗哌卡因相比,在超声引导下肌间沟臂丛神经阻滞中应用0.5%罗哌卡因的麻醉效果及安全性更优,具有较高的临床推广价值。

Objective To investigate the anesthesia effect of different concentrations of ropivacaine for ultrasound-guided brachial plexus block in the intermuscular groove.Methods A total of 90 patients who underwent upper extremity surgery in our hospital from July 2019 to July 2020 were selected as the research subjects,and they were divided into two groups according to the random number table method,with 45 cases in each group.The control group was given subcutaneous injection of 0.3%ropivacaine,and the observation group was given subcutaneous injection of 0.5%ropivacaine.The anesthesia effect,serum cardiac troponinⅠ(CTnⅠ),creatine kinase isoenzyme(CK-MB)level,systolic blood pressure(SBP)levels before and after anesthesia and indicators of anesthesia time,pain block rate,and occurrence of adverse reactions were compared between the two groups.Results The excellent and good rate of anesthesia in the observation group was 97.78%,which was higher than 82.22%in the control group,and the difference was statistically significant(P<0.05).After anesthesia,the level of SBP in the observation group was lower than that in the control group,while the levels of CTnⅠand CK-MB in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The total pain block rates of median nerve,ulnar nerve,radial nerve and musculocutaneous nerve in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The onset time of anesthesia in the observation group was shorter than that in the control group,and the duration of analgesia and the time required for motor function recovery were longer than those in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with 0.3%ropivacaine,the application of 0.5%ropivacaine in the ultrasound-guided brachial plexus block in the intermuscular groove has better anesthetic effect and safety of,and has higher clinical value.