低浓度罗哌卡因在超声引导下肌间沟臂丛神经阻滞上肢骨折手术中的应用效果

Effect of low concentration ropivacaine in ultrasonic-guided intermuscular sulcus brachial plexus block for surgery of upper limb fracture

目的探讨上肢骨折手术患者应用低浓度罗哌卡因超声引导下肌间沟臂丛神经阻滞的效果。方法选择2018年7月至2021年6月本院行手术治疗的上肢骨折患者112例,将住院号第5位数为单号的患者纳入对照组,将住院号第5位数为双号的患者纳入研究组,各56例。所有患者均行超声引导下肌间沟臂丛神经阻滞,麻醉药物为罗哌卡因,对照组用药浓度为0.5%,研究组用药浓度为0.25%。比较两组神经阻滞情况、镇痛持续时间、运动阻滞恢复时间、不良反应。结果两组正中神经、尺神经、肌皮神经及桡神经阻滞情况相比,差异无统计学意义(P>0.05)。与对照组相比,研究组镇痛持续时间、运动阻滞恢复时间短,不良反应发生率低,差异有统计学意义(P<0.05)。结论上肢手术患者应用低浓度罗哌卡因超声引导肌间沟臂丛神经阻滞可获得良好的神经阻滞效果,运动阻滞恢复时间短,且不良反应少,安全性高。

Objective To explore the effect of low concentration ropivacaine in ultrasonic-guided intermuscular sulcus brachial plexus block for surgery of upper limb fracture.Methods From July 2018 to June 2021,112 patients with upper limb fracture who underwent surgical treatment in our hospital were selected.The patients with single fifth digit of admission number were included in the control group,and the patients with double fifth digit of admission number were divided into the study group,with 56 cases in each group.All patients received ultrasonic-guided intermuscular sulcus brachial plexus block with ropivacaine(0.5%in the control group and 0.25%in the study group).The nerve block,duration of analgesia,recovery time of exercise block and adverse reactions were compared between the two groups.Results There was no significant difference in median nerve,ulnar nerve,musculocutaneous nerve and radial nerve block between the two groups(P>0.05).Compared with the control group,the duration of analgesia and recovery time of exercise block were shorter in the study group,and the incidence of adverse reactions was lower,with statistical significance(P<0.05).Conclusion Ultrasound-guided intermuscular sulcus brachial plexus block with low concentration of ropivacaine can achieve good nerve block effect in patients undergoing upper limb surgery.