超声引导下相同剂量不同浓度罗哌卡因锁骨上臂丛神经阻滞效果的比较

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摘要目的比较超声引导下相同剂量不同浓度罗哌卡因锁骨上臂丛神经阻滞的效果。方法选择2015年5月～2017年5月在本院行单侧上肢手术患者90例，将其随机分成3组，每组30例。A组给予0.25%罗哌卡因40 ml，B组给予0.5%罗哌卡因20 ml，C组给予0.75%罗哌卡因13.3 ml。比较三组的各神经（肌皮神经、桡神经、尺神经、正中神经）感觉和运动阻滞起效时间、阻滞持续时间，阻滞成功率及并发症发生率。结果 A组的药物注射时间明显长于B、C组，差异有统计学意义（P＜0.05）。三组患者的各神经感觉阻滞起效时间比较，差异无统计学意义（P＞0.05），B组患者的感觉阻滞持续时间明显长于A、C组，A组长于C组，差异均有统计学意义（P＜0.05）；A、B组患者的感觉阻滞成功率明显高于C组，差异有统计学意义（P＜0.05）。A组患者的各神经运动阻滞起效时间明显长于B、C组，差异有统计学意义（P＜0.05）；B组患者的运动阻滞持续时间明显长于A、C组，A组长于C组，差异有统计学意义（P＜0.05）；A、B组患者的运动阻滞成功率高于C组，差异有统计学意义（P＜0.05）。A组患者的并发症总发生率高于B、C组，差异有统计学意义（P＜0.05）。结论超声引导下锁骨上臂丛神经阻滞中，相同剂量（100 mg）的0.5%罗哌卡因起效快、作用持续时间长，阻滞成功率高，并发症发生率低。

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关键词 ：超声, 相同剂量, 罗哌卡因, 锁骨上臂丛神经阻滞

Abstract：Objective To comparison the supraclavicular brachial plexus block effect of different concentration and same dose Ropivacaine under ultrasound guidance.Methods A total of 90 patients given unilateral upper limb surgery in our hospital from May 2015 to May 2017 were selected and they were randomly divided into three groups,and there were 30 patients in each group.Group A received 40 ml of 0.25%Ropivacaine,group B received 20 ml of 0.5%Ropivacaine,and group C received 13.3 ml of 0.75%Ropivacaine.Onset and duration time of sensory and motor block of each nerve(musculocutaneous nerve,radial nerve,ulnar nerve,median nerve),the success rate of block and the incidence of complications among the three groups were compared.Results Drug injection time in group A was significantly longer than that in group B and C,and the differences were statistically significant(P＜0.05).There was no significant difference in the onset time of sensory block for each nerve in patients among the three groups(P＞0.05),the duration time of sensory block in patients of group B was significantly longer than that in group A and C,and group A was longer than that in group C,and the differences were statistically significant(P＜0.05).The success rate of sensory block in patients of group A and group B were significantly higher than those in group C,and the differences were statistically significant(P＜0.05).The onset time of motor block for each nerve in patients of patients of group A was significantly longer than that in group B and C,and the differences were statistically significant(P＜0.05),and the duration time of motor block in patients of group B was significantly longer than that in group A and C,and group A was significantly longer than that in group C,and the differences were statistically significant(P＜0.05).The success rate of motor block in patients of group A and B were significantly higher than those in group C,and the differences were statistically significant(P＜0.05).The total incidence of complications in group A was higher than that in group B and C,and the differences were statistically significant(P＜0.05).Conclusion0.5%Ropivacaine of the same dose(100 mg)has a rapid onset,a long duration,a high success rate and a low incidence of complications for supraclavicular brachial plexus block under ultrasound guidance.

Key words： Ultrasound Same dose Ropivacaine Supraclavicular brachial plexus block

基金资助:江西省卫生计生委科技计划项目（20155262）

作者简介: 龙小飞（1977-），男，硕士，主治医师，主要研究方向：超声引导神经阻滞

引用本文:

龙小飞;房晓薇;周斌;曹建;余树春;罗振中. 超声引导下相同剂量不同浓度罗哌卡因锁骨上臂丛神经阻滞效果的比较[J]. 中国当代医药, 2018, 25(27): 4-7.
LONG Xiao-fei;FANG Xiao-wei;ZHOU Bin;CAO Jian;YU Shu-chun;LUO Zhen-zhong. Effect comparison of supraclavicular brachial plexus block of different concentration and same dose Ropivacaine under ultrasound guidance. 中国当代医药, 2018, 25(27): 4-7.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2018/V25/I27/4

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