摘要
目的 探讨罗哌卡因复合利多卡因用于手部创伤手术于锁骨上臂丛神经麻醉中的效果。方法 对东莞市茶山医院2021年11月—2022年11月收治的52例手部创伤患者开展回顾性分析,所有患者均接受手术治疗,根据麻醉药物使用方案的不同实施分组。将26例单独应用罗哌卡因进行锁骨上臂丛神经麻醉的患者纳入常规组,26例采用罗哌卡因复合利多卡因进行锁骨上臂丛神经麻醉的患者则归入复合组。麻醉后,对其感觉、运动阻滞起效时间与持续时间实施记录;比较2组麻醉前(T_(1))、麻醉后10 min(T_(2))、麻醉后30 min(T_(3))以及手术结束时(T_(4))的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、血氧饱和度(saturation of blood oxygen,SpO_(2))指标;同时对2组麻醉优良率实施评估。结果 麻醉后,复合组感觉、运动神经阻滞起效时间均较常规组早,且与常规组比较,复合组感觉、运动神经阻滞持续时间更长(P<0.05);2组各时间段的MAP、HR及SpO_(2)比较,差异无统计学意义(P>0.05),但常规组T_(2)、T_(3)的MAP、HR及SpO_(2)水平与其T_(1)比较,差异有统计学意义(P<0.05),而复合组MAP、HR、SpO_(2)的T_(2)、T_(3)、T_(4)与其同组T_(1)比较,差异无统计学意义(P>0.05);复合组麻醉优良率为100%,高于常规组的84.62%(P<0.05)。结论 为手部创伤患者提供罗哌卡因复合利多卡因的麻醉方案能有效对其感觉、运动神经进行早期阻滞,且阻滞持续时间较长;同时,该方案未对患者生命体征的平稳性造成明显影响,麻醉效果值得肯定,可作为臂丛神经麻醉的优选方案。
Objective To investigate the effect of ropivacaine combined with lidocaine in supraclavicular brachial plexus anesthesia for hand trauma surgery.Methods A retrospective analysis was performed on 52 patients with hand trauma admitted to Chashan Hospital of Dongguan from November2021 to November 2022.All patients received surgical treatment.According to different implementation groups of narcotic drug use,26 patients who received supraclavicular brachial plexus anesthesia with ropivacaine alone were included in the conventional group.Twenty-six patients who received ropivacaine combined with lidocaine for supraclavicular brachial plexus anesthesia were classified into the complex group.After anesthesia,the onset time and duration of sensory and motor block were recorded,and the mean arterial pressure (MAP),heart rate (HR) and saturation of blood oxygen (SpO_2) indexes of the two groups were compared before anesthesia (T_1),10 min after anesthesia (T_2),30 min after anesthesia (T_3) and at the end of surgery (T_4).At the same time,the good and good rates of anesthesia in the two groups were evaluated.Results After anesthesia,the onset time of sensory and motor nerve block in complex group was earlier than that in conventional group,and the duration of sensory and motor nerve block in complex group was longer than that in conventional group(P<0.05).There were no significant differences in MAP,HR and SpO_(2) between the two groups at different time periods (P>0.05),but there were significant differences in MAP,HR and SpO_(2) levels between T_(2) and T_(3) in the conventional group compared with T_1(P<0.05).There was no significant difference in T_2,T_(3) and T_(4) of MAP,HR and SpO_(2) in the complex group compared with T_(1) in the same group (P>0.05).The excellent and good rate of anesthesia in combination group was 100%,which was higher than that in complex group (84.62%)(P<0.05).Conclusion Ropivacaine combined with lidocaine can effectively block sensory and motor nerves in the early stage for patients with hand trauma,and the duration of the block is longer.At the same time,the program has no significant effect on the stability of patients'vital signs,and the anesthetic effect is worthy of affirmation,and can be used as the best choice for brachial plexus anesthesia.
作者
陈银玲
苏晓娜
甘梅喜
谭国龙
CHEN Yinlin;SU Xiaona;GAN Meixi;TAN Guolong(Department of Anesthesiology,Chashan Hospital of Dongguan,Dongguan Guangdong 523381,China)
出处
《中国卫生标准管理》
2024年第4期136-139,共4页
China Health Standard Management
关键词
罗哌卡因
利多卡因
手部创伤
臂丛神经麻醉
体征波动
麻醉质量
ropivacaine
lidocaine
trauma to the hand
brachial plexus anesthesia
fluctuation of physical signs
quality of anesthesia
