实用疼痛学杂志
實用疼痛學雜誌
실용동통학잡지
PAIN CLINIC JOURNAL
2015年
2期
107-111
,共5页
温度%罗哌卡因%臂丛神经%神经传导阻滞%超声引导
溫度%囉哌卡因%臂叢神經%神經傳導阻滯%超聲引導
온도%라고잡인%비총신경%신경전도조체%초성인도
Temperature%Ropivacaine%Brachial plexus%Nerve block%Ultrasound guidance
目的 探讨超声引导下不同温度罗哌卡因臂丛神经连续阻滞的临床麻醉与术后镇痛效果.方法 超声引导下不同温度0.5％罗哌卡因(0.5 ml/kg)臂丛神经阻滞上肢手术患者60例,随机分为3组(每组20例):A组(安瓿20℃),B组(安瓿30℃)和C组(安瓿37℃),A组患者单次阻滞,B、C组患者留置导管.记录切皮前T1(注射后5 min),T2(注射后10 min),T3(注射后15 min),T4(注射后20 min)时和术中麻醉效果评分,记录术后24 h时VAS评分和PCA按压次数.结果 与T1时比较,T2,T3,T4时各组患者各神经支效果评分明显增高(P＜0.05);与A组患者比较,C组患者T1时肌皮神经效果评分明显增高,T4时正中神经、桡神经、肌皮神经效果评分明显增高(P＜0.05).与A组患者比较,B、C组患者术中麻醉效果评分明显增高,术后24 h疼痛评分、PCA按压次数显著降低(P＜0.05).B组与C组麻醉效果比较差异无统计学意义(P＞0.05).结论 37℃罗哌卡因药液臂丛神经阻滞术中麻醉效果评分明显增高,超声引导臂丛神经连续阻滞是成人上肢手术安全有效的麻醉选择,术后镇痛效果良好.
目的 探討超聲引導下不同溫度囉哌卡因臂叢神經連續阻滯的臨床痳醉與術後鎮痛效果.方法 超聲引導下不同溫度0.5％囉哌卡因(0.5 ml/kg)臂叢神經阻滯上肢手術患者60例,隨機分為3組(每組20例):A組(安瓿20℃),B組(安瓿30℃)和C組(安瓿37℃),A組患者單次阻滯,B、C組患者留置導管.記錄切皮前T1(註射後5 min),T2(註射後10 min),T3(註射後15 min),T4(註射後20 min)時和術中痳醉效果評分,記錄術後24 h時VAS評分和PCA按壓次數.結果 與T1時比較,T2,T3,T4時各組患者各神經支效果評分明顯增高(P＜0.05);與A組患者比較,C組患者T1時肌皮神經效果評分明顯增高,T4時正中神經、橈神經、肌皮神經效果評分明顯增高(P＜0.05).與A組患者比較,B、C組患者術中痳醉效果評分明顯增高,術後24 h疼痛評分、PCA按壓次數顯著降低(P＜0.05).B組與C組痳醉效果比較差異無統計學意義(P＞0.05).結論 37℃囉哌卡因藥液臂叢神經阻滯術中痳醉效果評分明顯增高,超聲引導臂叢神經連續阻滯是成人上肢手術安全有效的痳醉選擇,術後鎮痛效果良好.
목적 탐토초성인도하불동온도라고잡인비총신경련속조체적림상마취여술후진통효과.방법 초성인도하불동온도0.5％라고잡인(0.5 ml/kg)비총신경조체상지수술환자60례,수궤분위3조(매조20례):A조(안부20℃),B조(안부30℃)화C조(안부37℃),A조환자단차조체,B、C조환자류치도관.기록절피전T1(주사후5 min),T2(주사후10 min),T3(주사후15 min),T4(주사후20 min)시화술중마취효과평분,기록술후24 h시VAS평분화PCA안압차수.결과 여T1시비교,T2,T3,T4시각조환자각신경지효과평분명현증고(P＜0.05);여A조환자비교,C조환자T1시기피신경효과평분명현증고,T4시정중신경、뇨신경、기피신경효과평분명현증고(P＜0.05).여A조환자비교,B、C조환자술중마취효과평분명현증고,술후24 h동통평분、PCA안압차수현저강저(P＜0.05).B조여C조마취효과비교차이무통계학의의(P＞0.05).결론 37℃라고잡인약액비총신경조체술중마취효과평분명현증고,초성인도비총신경련속조체시성인상지수술안전유효적마취선택,술후진통효과량호.
Objective To investigate the efficacy of ultrasound guided continuous brachial plexus block with ropivacaine in different temperatures during operative anesthesia and postoperative analgesia.Methods Sixty patients undergoing upper extremity surgery under brachial plexus block guided by ultrasound with ropivacaine in different temperatures were randomly divided into three groups (20 patients in each group):group A (20 ℃),group B (30 ℃) and group C (37 ℃).Ropivacaine was injected at ampule 20,30 and 37 ℃ in group A,B and C respectively.Patients in group A were injected without catheter;patients in group B and C were placed a catheter through the needle.The effective scores before the operation at T1 (5 min after injection),T2 (10 min after injection),T3 (15 min after injection),T4 (20 min after injection),the effective scores of intra-operation,VAS in 24 h after the operation and bolus times of PCA pumps of all patients were recorded.Results Compared with T1,the effective scores of every nerve branch of all patients in T2,T3 and T4 were increased significantly (P ＜ 0.05).Compared with the patients in group A at T1,the effective scores of musculocutaneous nerve in group C were increased significantly;the scores of median nerve,radial nerve,musculocutaneous nerve in group C were significantly increased at T4 (P ＜ 0.05).Compared with patients in group A,the effective scores of intraoperation in group B and group C were increased significantly,and VAS of 24 h after the operation,bolus times of PCA pumps were decreased significantly (P ＜ 0.05).There were no significant differences in the effective scores between group B and C.Conclusion Warming of ropivacaine to the body temperature increases the operative anesthetic effectiveness of the continuous brachial plexus block guided by ultrasound is a safe and effective anesthesia option for upper extremity surgical operation in adult patients with good effect of postoperative analgesia.
