临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2014年
15期
1292-1294
,共3页
臂丛神经麻醉%超声引导%罗哌卡因%浓度
臂叢神經痳醉%超聲引導%囉哌卡因%濃度
비총신경마취%초성인도%라고잡인%농도
brachial plexus block%ultrasound-guided%ropivacaine%concentration
目的探讨不同浓度罗哌卡因对超声引导腋路臂丛神经阻滞效果的影响。方法 ASAⅠ~Ⅱ级拟择期行前臂或者手部手术的病人120例,在超声引导下行腋路臂丛神经阻滞,随机分为四组:A组给予0.25%的罗哌卡因,B组给予0.33%的罗哌卡因,C组给予0.4%的罗哌卡因,D组给予0.5%的罗哌卡因,每组30例,均给予罗哌卡因32 ml。记录臂丛神经阻滞起效时间、镇痛持续时间;评估臂丛神经阻滞效果;观察记录不良反应。结果随着罗哌卡因浓度的增高,起效时间逐渐缩短,镇痛维持时间逐渐延长,每两组之间比较,差异均有统计学意义( P ﹤0.05)。四组阻滞效果差异无统计学意义( P ﹥0.05)。A组优秀率83.3%,优良率93.3%;B组优秀率90.0%,优良率96.7%;C组优秀率96.7%,优良率100%;D组优秀率100%。四组病人均未出现不良反应。结论超声引导下行腋路臂丛神经阻滞,0.25%~0.50%罗哌卡因都是可行的,从“较低的浓度达到100%阻滞成功率”的角度评价,0.4%罗哌卡因效果最好。
目的探討不同濃度囉哌卡因對超聲引導腋路臂叢神經阻滯效果的影響。方法 ASAⅠ~Ⅱ級擬擇期行前臂或者手部手術的病人120例,在超聲引導下行腋路臂叢神經阻滯,隨機分為四組:A組給予0.25%的囉哌卡因,B組給予0.33%的囉哌卡因,C組給予0.4%的囉哌卡因,D組給予0.5%的囉哌卡因,每組30例,均給予囉哌卡因32 ml。記錄臂叢神經阻滯起效時間、鎮痛持續時間;評估臂叢神經阻滯效果;觀察記錄不良反應。結果隨著囉哌卡因濃度的增高,起效時間逐漸縮短,鎮痛維持時間逐漸延長,每兩組之間比較,差異均有統計學意義( P ﹤0.05)。四組阻滯效果差異無統計學意義( P ﹥0.05)。A組優秀率83.3%,優良率93.3%;B組優秀率90.0%,優良率96.7%;C組優秀率96.7%,優良率100%;D組優秀率100%。四組病人均未齣現不良反應。結論超聲引導下行腋路臂叢神經阻滯,0.25%~0.50%囉哌卡因都是可行的,從“較低的濃度達到100%阻滯成功率”的角度評價,0.4%囉哌卡因效果最好。
목적탐토불동농도라고잡인대초성인도액로비총신경조체효과적영향。방법 ASAⅠ~Ⅱ급의택기행전비혹자수부수술적병인120례,재초성인도하행액로비총신경조체,수궤분위사조:A조급여0.25%적라고잡인,B조급여0.33%적라고잡인,C조급여0.4%적라고잡인,D조급여0.5%적라고잡인,매조30례,균급여라고잡인32 ml。기록비총신경조체기효시간、진통지속시간;평고비총신경조체효과;관찰기록불량반응。결과수착라고잡인농도적증고,기효시간축점축단,진통유지시간축점연장,매량조지간비교,차이균유통계학의의( P ﹤0.05)。사조조체효과차이무통계학의의( P ﹥0.05)。A조우수솔83.3%,우량솔93.3%;B조우수솔90.0%,우량솔96.7%;C조우수솔96.7%,우량솔100%;D조우수솔100%。사조병인균미출현불량반응。결론초성인도하행액로비총신경조체,0.25%~0.50%라고잡인도시가행적,종“교저적농도체도100%조체성공솔”적각도평개,0.4%라고잡인효과최호。
Objective To investigate the effects of different concentration of ropivacaine on axillary brachial plexus block under the guid-ance of ultrasound. Methods 120 patients undergoing elective surgery of forearm or hand were randomly divided into four groups:group A with 0. 25% ropivacaine 32 ml,group B with 0. 33% ropivacaine 32 ml,group C with 0. 4 % ropivacaine 32 ml,group D with 0. 5% ropivacaine 32 ml. The onset time and duration of analgesia were recorded. the effects of brachial plexus block were evaluated. The adverse reactions were ob-served. Results With the increase of concentration of ropivacaine,the onset time became shorter( P ﹤0. 05)and duration of analgesia became longer( P ﹤0. 05). There were no significant difference in the effects of brachial plexus block( P ﹥0. 05). The rates of excellent block effects were 83. 3%,90. 0%,96. 7%,100%,respectively. The rates of good block effects were 93. 3%,96. 7%,100. 0%,100%,respectively. No complications occurred in four goups. Conclusion 0. 25% ~0. 50% ropivacaine can be used in axillary brachial plexus block under guidance of ultrasound. 0. 4% ropivacaine may achieve perfect block effects though lower concentration. .