摘要
目的 观察罗哌卡因应用于臂丛神经阻滞的临床效果。方法 选择ASA Ⅰ～Ⅱ级上肢手术病人30例,随机分为三组,每组10例。分别以0.75％罗哌卡因、0.5％罗哌卡因和0.5％布比卡因采用肌间沟法进行臂丛神经阻滞,注入量20ml。分别记录病人感觉阻滞和运用阻滞的起效时间,峰值时间(达到完全阻滞可以开始手术的时间),追加阻滞药物的比率,术中病人对阿片类药物的需要,病人的满意程度等指标。对比各组间的各项指标。结果 两组罗哌卡因与0.5％布比卡因比较在注射10、15、20 min后达到完全的感觉和运动阻滞的比率较高(P<0.01)。罗哌卡因组的平均峰值时间明显短于布比卡因组(R50=16.3±3.16min,R75=14.6±3.33min,B=22.4±4.17 min,P<0.05)。根据病人术中对阿片类药的需要和全部病人的满意程度,认为罗哌卡因有较高的麻醉质量(P<0.05)。其他各项指标无显著差异。结论 罗哌卡因在臂丛神经阻滞中出现了较布比卡因平均峰值时间短、阻滞完善的优越性。在肌间沟臂丛神经阻滞中应该使用0.5％的罗哌卡因。
Objective:Investigate some clinical features of scalene gap brachial plexus block anaesthesia with ropivacaine. Methodsr 30 ASA physical status Ⅰ or Ⅱ patients undergoing upper limb surgery were selected and randomly divided into 3 groups. They received 20 ml of the local anaesthetic solution, differently 0.75% , 0.5% ropivacaine and 0.5% bupivaeaine into scalene gap. Onset time in each of the stimulated nerves was recorded both for the sensory and motor block. Peak tune (ready for surgery), rate of supplemental blocks, need for intraoperative opi-oids, and patient satisfaction were also recorded. Results: The rate of complete sensory and motor block observed with both ropivacaine groups was higher at 10,15 and 20 minutes post-injection ( PP.<0.01) , compared with 0.5% bupivaeaine. The mean peak time was shorter with ropivacaine than with bupivaeaine (R50 = 16.3 ?3 .16 minutes, R75 = 14.6 ?3.33 minutes B = 22.4 ?4.17 minutes, PP.<0.05) . The quality of the anesthesia was higher with ropivacaine, as measured by the intraoperative needs for opioids and the overall patien's satisfaction (P<0.05) . No significant differences were noted with all the other studied parameters.Conclusion:Ropivacaine has a shorter average peak time and better effects over bupiv(?)tine for scalene gap brachial plexus block. 0.5% ropivacaine should be used to perform scalene gap brachial plexus blocks.
出处
《河南外科学杂志》
2001年第3期252-254,共3页
Henan Journal of Surgery
