摘要
目的比较不同容量和浓度罗哌卡因经喙突入路臂丛神经阻滞的安全性及其效果。方法选择择期上肢手术患者150例,随机分成三组,每组50例。将罗哌卡因150mg稀释到30ml(0.5%,A组)、40ml(0.375%,B组)和50ml(0.3%,C组)。在喙突内下2cm处,经神经刺激器引导下注入罗哌卡因。记录三组不良反应、臂丛神经感觉和运动阻滞起效时间、感觉、运动阻滞时间及阻滞成功率。结果 A组(82%)阻滞成功率明显低于B组(98%)、C组(94%)(P<0.05)。C组感觉、运动阻滞起效时间明显长于A、B组(P<0.05);感觉、运动阻滞时间明显短于A、B组(P<0.05)。三组发生局麻药中毒A、B和C组分别为4例、0例和2例。结论在喙突入路臂丛神经阻滞中150mg罗哌卡因40ml更安全,麻醉阻滞成功率更高,临床效果更好。
Objective To investigate the safety and clinical outcome of brachial plexus block （BPB） through modified coracoid approach using the same dose of ropivacaine in various volume. Methods One hundred fifty patients undergoing upper extremity surgery were randomly divided into group A（0. 5%,30 ml）, group B（0. 375%, 40 ml） and group C（0.3%,50 ml） with 50 cases each. Ropivacaine 150 mg was diluted into 30 ml, 40 ml or 50 ml. BPB was performed at the point 2 cm caudal and 2 cm medial to the coracoid directed by nerve stimulator. Adverse reactions, the sensory and motor blockade onset time, the successful rate was recorded. Results The rate of successful blockade in group A （82%） was lower than that in group B （98%） and C （94%） （P〈0.05）. The sensory and motor blockade onset time in group C was longer than that in group A and B（P〈0.05）, and sensory and motor blockade durations in group C was shorter than that in group A and B（P〈0. 05）. There were 4,0 and 2 patients who had an local anesthetics intoxication in group A, B and C, respectively. Conclusion 150 mg ropivacaine 40 ml provides safer, higher successful rate of blockade, and better clinical outcome during BPB through coracoid approach.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第1期16-18,共3页
Journal of Clinical Anesthesiology
