局部麻醉药物温度对超声引导下锁骨下臂丛神经阻滞的影响

Effect of Local Anesthesia Drug Temperature on Subclavian Brachial Plexus Nerve Block Under Ultrasound Guidance

目的:分析局部麻醉药物给药时的不同温度对超声引导下锁骨下臂丛神经阻滞的影响。方法:选取2019年3月—2023年5月于江苏省南通市通州区平潮中心卫生院接受上肢手术的患者57例为研究对象,随机将患者分为低温组、室温组和加热组,各19例。三组患者均采用0.4%罗哌卡因作为麻醉药物,注射剂量15mL,低温组麻醉药物在注射前温度保持在4℃,室温组温度为25℃,加热组温度为37℃。在超声下进行锁骨下臂丛神经阻滞,比较三组患者感觉和运动阻滞的发生时间和持续时间、并发症发生情况。结果:室温组、加热组的运动阻滞和感觉阻滞发生时间短于低温组,加热组运动阻滞和感觉阻滞发生时间短于室温组,差异有统计学意义(P<0.05)。三组运动阻滞持续时间比较,差异无统计学意义(P>0.05);室温组和加热组感觉阻滞持续时间长于低温组,差异有统计学意义(P<0.05)。三组患者在术后均未出现并发症。结论:在相对较高温度下使用局部麻醉药物会缩短超声引导下锁骨下臂丛神经阻滞发生的时间。

Objective:To analyze the effect of different temperatures of local anesthesic drug dosing on subclavian brachial plexus nerve block under ultrasound guidance.Methods:A total of 57 patients who received upper limb surgery in Jiangsu Province Nantong City Tongzhou District Pingchao Center Hospital from March 2019 to May 2023 were selected as the study subjects.The patients were randomly divided into low temperature group,room temperature group and heating group,with 19 cases in each group.Patients in all three groups were treated with 0.4%ropivacaine as anesthetic drug with an injection dose of 15 mL.The temperature of anesthetic drug in the low temperature group was kept at 4℃before injection,the temperature in the room temperature group was 25℃,and the temperature in the heating group was 37℃.Subclavian brachial plexus nerve block was performed under ultrasound guidance.The onset time and duration of sensory and motor block as well as the complications were compared among the three groups.Results:The onset time of sensory and motor block in room temperature group and heating group was shorter than that in low temperature group,the onset time of sensory and motor block in heating group was shorter than that in room temperature group,and the difference was statistically significant(P<0.05).There was no significant difference in the duration of motor block among the three groups(P>0.05).The duration of sensory block in room temperature group and heating group was longer than that in low temperature group,and the difference was statistically significant(P<0.05).No patients developed complications after surgery among the three groups.Conclusion:The use of local anesthetic drugs at relatively high temperature can shorten the onset time of subclavian brachial plexus nerve block under ultrasound guidance.