摘要
目的分析超声引导定位下腋路臂丛神经阻滞利多卡因复合罗哌卡因剂量的使用情况。方法选取2016-02—12新疆维吾尔自治区第二济困医院收治的择期行上肢手术98例患者为观察对象,随机分为A、B、C3组,A组、B组各33例,C组32例。3组患者使用相同的麻醉药(2%利多卡因复合0.75%罗哌卡因)。A、B、C 3组麻醉药使用总剂量分别为20、25、30mL。记录3组患者各神经(桡神经、正中神经、尺神经、肌皮神经)感觉组织起效时间、麻醉持续时间和阻滞效果,评价不同剂量利多卡因复合罗哌卡因在腋路臂丛神经阻滞麻醉中的效果,观察3组患者有无麻醉不良反应的发生。结果 A组各神经麻醉起效时间均长于B、C 2组(P<0.05),且阻滞效果低于B、C 2组(P<0.05);A组麻醉持续时间均短于B、C 2组(P<0.05);A、B、C 3组麻醉优良率分别为75.8%(25/33)、97.0%(32/33)和100.0%(32/32),A组麻醉优良率明显低于B、C 2组(P<0.05)。3组患者均未出现麻醉相关不良反应。结论 30mL 2%利多卡因复合0.75%罗哌卡因在超声引导定位下腋路臂丛神经阻滞麻醉中具有较高的应用效果,见效快、持续时间长且安全性高,能够提高手术麻醉效果,是一种理想的麻醉方案。
Objective To analyze the application of lidocaine combined with ropivacaine dose in the treatment of axillary brachial plexus block with ultrasound guided positioning. Methods A total of 98 patients undergoing elective upper extremity sur gery were selected from February 2016 to December 2016 in the second economic hospital in Xinjiang Uygur Autonomous Region. The patients were randomly divided into groups A,B,and C. There were 33 patients in each group A and B. There were only 32 pa tients in the C group. All three patients used the same anesthetic （2O/0o lidocaine and 0.75% ropivacaine）. The total dose of anes thetics used in groups A,B,and C was 20,25,and 30 mL,respectively. The onset time,anesthesia duration,and block effect of the sensory tissues of all nerves （branch nerve,median nerve,ulnar nerve,and musculocutaneous nerve） in 3 groups of patients were recorded. Different doses of lidocaine and ropivacaine were evaluated in the axillary brachial plexus. In the effect of nerve block an esthesia,the occurrence of adverse reactions to anesthesia was observed in the three groups of patients. Results The onset time of each nerve anesthesia in group A was longer than that of group B and C （P〈0.05） ,and the block effect was lower than that of group B and C （P〈0.05）. The duration of anesthesia in group A was shorter than that of group B and C （P〈0.05） ;The anes thesia rate in group A,B,and C was 75.8% （25/33） ,97.0% （32/33） ,and 100.0% （32/32） ,respectively. The anesthesia rate in group A was significantly lower than that in group B,C group （P〈0.05）. There were no anesthesia related adverse reactions in all three groups. Conclusion 30 mL2%idocainecombined with0.75% ropivacaine has a high application effect in the brachialplex us block anesthesia with ultrasound guided localization. It has quick results, long duration and high safety,and can improve the sur gical anesthesia. The effect is an ideal anaesthesia program.
作者
张华
焦天明
ZHANG Hua;JIAO Tianming(Department of Anesthesiology,Second Jiji Hospital,Xinjiang Uygur Autonomous Region,Urumqi 830026,China)
出处
《中国实用神经疾病杂志》
2018年第18期1998-2005,共8页
Chinese Journal of Practical Nervous Diseases
