不同浓度罗比卡因腰丛联合坐骨神经阻滞用于膝关节镜手术的比较  

A comparison between two different concentrations of ropivacaine for combined lumbar plexus and sciatic nerve block for knee arthroscopy

作　　者：陈曦[1] 吴昱[1] 丰新民[1] 毕好生[2] 

机构地区：[1]武汉市第一医院麻醉科,430022 [2]华中科技大学同济医学院附属同济医院麻醉科

出　　处：《临床麻醉学杂志》2005年第11期755-757,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察一定剂量的罗比卡因配成不同浓度溶液用于腰丛联合坐骨神经阻滞在膝关节镜手术的麻醉效果比较。方法40例拟行单侧膝关节镜手术患者随机分为A、B两组,每组20例,均在神经刺激仪定位下行腰丛联合坐骨神经阻滞,在腰丛神经和坐骨神经处均分别注入罗比卡因150 mg。A组将150 mg罗比卡因稀释到20 ml使用,即浓度为0.75%;B组稀释到30 ml,即浓度为0.5%。观察患者感觉和运动阻滞起效时间及维持时间,以及麻醉满意程度。结果两组患者感觉阻滞维持时间差异无显著性(P>0.05),感觉及运动阻滞起效时间A组比B组明显缩短(P<0.05),而运动阻滞维持时间A组明显延长(P<0.05),麻醉满意度B组明显优于A组(P<0.05)。结论A组麻醉比B组起效快,但只运动阻滞时间明显延长,且麻醉满意度较差。所以在相同剂量的情况下,用0.5%的罗比卡因比用0.75%的罗比卡因行腰丛联合坐骨神经阻滞更适合于膝关节镜手术。Objective To compare the efficiency of the same dose ropivacaine in different concentrations used for combined lumbar plexus and sciatic nerve block for knee arthroscopy. Methods Forty patients scheduled for knee arthroscopic surgery were randomly divided into groups A and B with 20 cases each. All patients were undergone lumbar plexus combined sciatic nerve block with the help of nerve stimulator, 150 mg ropivacaine was administered at each point. In group A, ropivacaine was diluted into 20 ml,with a concentration of 0.75%. In group B,ropivacaine was diluted into 30 ml with a concentration of 0.5 %. The onset time and duration of sensory and motor block were recorded, the patients＇ satisfaction was evaluated as well. Results There was no significant difference in the du- ration of sensory nerve block（P〈0.05）. The onset time of group A was shorter than that of group B （P〈0.05）,and the duration of motor block was longer than that of group B（P〈0.05）. The patients＇ satisfaction of group B was higher than that of group A（P〈0.05）. Conclusions In the same dose, 0.5% ropivacaine will produce a better anesthetic effect in lumbar plexus combined sciatic nerve block than 0.75% ropivacaine for knee arthroscopy.

关 键 词：罗比卡因 腰丛神经阻滞 坐骨神经阻滞 神经刺激仪 关节镜 

分 类 号：R614[医药卫生—麻醉学]