中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
8期
1221-1225
,共5页
严明%沈跃华%周薇%李祖阁
嚴明%瀋躍華%週薇%李祖閣
엄명%침약화%주미%리조각
臂丛神经阻滞%地塞米松%地佐辛
臂叢神經阻滯%地塞米鬆%地佐辛
비총신경조체%지새미송%지좌신
Brachial plexus block%Dexamethasone%Dezocine
目的 探讨地塞米松联合地佐辛用于臂丛神经阻滞术后镇痛中的效果.方法 将单侧前臂手术患者60例完全随机分为试验组和对照组,各30例.对照组应用1％盐酸利多卡因+0.25％罗哌卡因(25 ml),试验组应用地塞米松10 mg+地佐辛0.1 mg/kg+ 1％盐酸利多卡因+0.25％罗哌卡因(25 ml),肌间沟法行臂丛神经阻滞.麻醉前和麻醉后5、10 min记录2组患者平均动脉压、心率、呼吸频率和脉搏血氧饱和度.观察2组麻醉起效时间、阻滞完善时间、麻醉维持时间.以视觉模拟评分(VAS)评价术后镇痛效果,记录术后镇痛药使用及不良反应发生情况.结果 2组患者麻醉前和麻醉后平均动脉压、心率、呼吸频率和脉搏血氧饱和度比较差异无统计学意义(P＞0.05).试验组麻醉起效时间、阻滞完善时间分别为(2.8±2.3)、(8.2 ±2.0)min,与对照组[(4.2±2.7)、(15.3±2.6) min]比较差异均有统计学意义(均P＜0.05);试验组麻醉维持时间为(560±121)min,明显长于对照组[(251±110)min] (P ＜0.05);试验组术后12、24、36、48 h VAS评分分别为(3.1±1.2)分、(3.2±1.1)分、(2.2±1.4)分、(2.0±1.2)分,与对照组[(7.2±1.6)分、(6.5±1.3)分、(5.8±1.3)分、(4.9±1.2)分]比较差异均有统计学意义(均P ＜0.05);术后镇痛药使用率试验组(10.0％,3/30)明显低于对照组(86.7％,26/30) (P ＜0.05);2组均未出现明显的不良反应,2组恶心、呕吐和嗜睡发生率差异无统计学意义(P＞0.05).结论 地塞米松复合地佐辛能明显增强臂丛神经的镇痛效果,且无明显不良反应.
目的 探討地塞米鬆聯閤地佐辛用于臂叢神經阻滯術後鎮痛中的效果.方法 將單側前臂手術患者60例完全隨機分為試驗組和對照組,各30例.對照組應用1％鹽痠利多卡因+0.25％囉哌卡因(25 ml),試驗組應用地塞米鬆10 mg+地佐辛0.1 mg/kg+ 1％鹽痠利多卡因+0.25％囉哌卡因(25 ml),肌間溝法行臂叢神經阻滯.痳醉前和痳醉後5、10 min記錄2組患者平均動脈壓、心率、呼吸頻率和脈搏血氧飽和度.觀察2組痳醉起效時間、阻滯完善時間、痳醉維持時間.以視覺模擬評分(VAS)評價術後鎮痛效果,記錄術後鎮痛藥使用及不良反應髮生情況.結果 2組患者痳醉前和痳醉後平均動脈壓、心率、呼吸頻率和脈搏血氧飽和度比較差異無統計學意義(P＞0.05).試驗組痳醉起效時間、阻滯完善時間分彆為(2.8±2.3)、(8.2 ±2.0)min,與對照組[(4.2±2.7)、(15.3±2.6) min]比較差異均有統計學意義(均P＜0.05);試驗組痳醉維持時間為(560±121)min,明顯長于對照組[(251±110)min] (P ＜0.05);試驗組術後12、24、36、48 h VAS評分分彆為(3.1±1.2)分、(3.2±1.1)分、(2.2±1.4)分、(2.0±1.2)分,與對照組[(7.2±1.6)分、(6.5±1.3)分、(5.8±1.3)分、(4.9±1.2)分]比較差異均有統計學意義(均P ＜0.05);術後鎮痛藥使用率試驗組(10.0％,3/30)明顯低于對照組(86.7％,26/30) (P ＜0.05);2組均未齣現明顯的不良反應,2組噁心、嘔吐和嗜睡髮生率差異無統計學意義(P＞0.05).結論 地塞米鬆複閤地佐辛能明顯增彊臂叢神經的鎮痛效果,且無明顯不良反應.
목적 탐토지새미송연합지좌신용우비총신경조체술후진통중적효과.방법 장단측전비수술환자60례완전수궤분위시험조화대조조,각30례.대조조응용1％염산리다잡인+0.25％라고잡인(25 ml),시험조응용지새미송10 mg+지좌신0.1 mg/kg+ 1％염산리다잡인+0.25％라고잡인(25 ml),기간구법행비총신경조체.마취전화마취후5、10 min기록2조환자평균동맥압、심솔、호흡빈솔화맥박혈양포화도.관찰2조마취기효시간、조체완선시간、마취유지시간.이시각모의평분(VAS)평개술후진통효과,기록술후진통약사용급불량반응발생정황.결과 2조환자마취전화마취후평균동맥압、심솔、호흡빈솔화맥박혈양포화도비교차이무통계학의의(P＞0.05).시험조마취기효시간、조체완선시간분별위(2.8±2.3)、(8.2 ±2.0)min,여대조조[(4.2±2.7)、(15.3±2.6) min]비교차이균유통계학의의(균P＜0.05);시험조마취유지시간위(560±121)min,명현장우대조조[(251±110)min] (P ＜0.05);시험조술후12、24、36、48 h VAS평분분별위(3.1±1.2)분、(3.2±1.1)분、(2.2±1.4)분、(2.0±1.2)분,여대조조[(7.2±1.6)분、(6.5±1.3)분、(5.8±1.3)분、(4.9±1.2)분]비교차이균유통계학의의(균P ＜0.05);술후진통약사용솔시험조(10.0％,3/30)명현저우대조조(86.7％,26/30) (P ＜0.05);2조균미출현명현적불량반응,2조악심、구토화기수발생솔차이무통계학의의(P＞0.05).결론 지새미송복합지좌신능명현증강비총신경적진통효과,차무명현불량반응.
Objective To observe the effect of dexamethasone combined with dezocine in brachial plexus block and postoperative analgesia.Methods Sixty patients undergoing brachial plexus block were randomly divided into two groups:control group (30 cases) and test group (30 cases).Control group received 1％ lidocaine + 0.25％ ropivacaine (25 nl); test group received dexamethasone 10 mg + dezocine 0.1 mg/kg + l％lidocaine + 0.25％ ropivacaine (25 ml); all patients undergoing brachial plexus block had interscalene route.Mean arterial pressure,heart rate,breathing rate and pulse oxygen saturation before and after anesthesia in two groups were recorded.The onset time of anaesthesia,the time for whole blocking and the duration of anaesthesia were observed.Postoperative analgesia was observed using visual analogue scale (VAS).The use of analgetic and side effects in two groups were recorded.Results There were no significant differences of mean arterial pressure,heart rate,breathing rate and pulse oxygen saturation before and after anesthesia in two groups.The onset time of anaesthesia and the time for whole blocking in test group were (2.8 ± 2.3) min and (8.2 ± 2.0) min,significantly shorter than those in control group [(4.2 ± 2.7) min and (15.3 ± 2.6) min] (P ＜0.05).The time for the duration of anaesthesia in test group was(560 ± 121) min,which was longer than that in control group (251 110) min (P ＜0.05).The VAS scores in test group were (3.1 ± 1.2),(3.2 ± 1.1),(2.2 ± 1.4),(2.0 ± 1.2) respectively at 12,24,36,48 h after operation,lower than thoses in control group [(7.2 ± 1.6),(6.5 ± 1.3),(5.8 ± 1.3),(4.9 ± 1.2)] (P＜0.05).The use of analgetic in test group was 10.0％ (3/30),which was markedly lower than that in control group (86.7％,26/30)(P ＜0.05).The incidence rate of side effects such as nausea,vomiting and sleepiness in two groups had no differences (P ＞ 0.05).Conclusion The effect of anaesthesia can be enhanced by dexamethasone and dezocine applied in brachial plexus block.
