不同剂量甲磺酸罗哌卡因用于小儿腋路臂丛神经阻滞的临床观察  

The Application of ropivacaine hydrochloride brachial plexus block used in upper extremity operation of pediatric patients

作　　者：曹飞[1] 孙晓峰[1] 赵宏[1] 

机构地区：[1]沈阳医学院奉天医院麻醉科,辽宁沈阳110024

出　　处：《沈阳医学院学报》2009年第2期94-95,共2页Journal of Shenyang Medical College

摘　　要：目的:观察不同剂量甲磺酸罗哌卡因用于小儿腋路臂丛神经阻滞的临床效果。方法:选择拟行上肢手术的患儿45例,随机等分为3组,用0.227%甲磺酸罗哌卡因行腋路臂丛神经阻滞,Ⅰ组0.5 ml/kg;Ⅱ组0.75 ml/kg;Ⅲ组1 ml/kg。分别记录手术前和切皮后3min患儿的SBP、DBP和HR及手术时肢体活动、寒战和辅助使用静脉麻醉药的情况。结果:Ⅰ组比Ⅱ、Ⅲ组患儿术中静脉麻醉药用量显著增多(P<0.05);Ⅰ组切皮时有4例肢体活动,SBP、DBP和HR明显增高,且神经阻滞持续时间显著短于Ⅱ、Ⅲ组(P<0.05)。Ⅲ组有5例出现寒战反应。结论:0.227%甲磺酸罗哌卡因用于小儿腋路臂丛神经阻滞,0.75ml/kg的剂量能产生较满意的临床效果。Objective： To compare the anesthetic effect on axillary brachial plexus block with different doses of ropivacaine mesylate in children. Methods： forty-five pediatric patients were ramdomly divided into three groups with 15 cases each. Axillary brachial plexus block was performed with 0. 227% ropivaciane mesylate. The systolic and diastolic blood pressure, and heart rate were measured before anesthesia and at 3 min after the incision of surgery; limb moving and shivering were recorded during operation. Results： The doses of general anesthetic in group Ⅰ were significantly much more than those in group Ⅱ and Ⅲ （P 〈 0. 05 ）. There were 4 patients whose limbs moved in group Ⅰ at the beginning of surgery. The systolic and diastolic blood pressure and heart rate were increased significantly after the incision of surgery in group Ⅰ than those in group Ⅱ and Ⅲ （ P 〈 0. 05 ）. The blockage time was significantly shorter in group Ⅰ than that in group Ⅱ and Ⅲ （ P 〈 0.05 ）. There were 5 patients shivered in group Ⅲ. Conclusion： The doses of 0. 75ml/kg of 0. 227% ropivacaine mesylate can get better effect as axillary brachial plexus block in children.

关 键 词：罗哌卡因 小儿 臂丛神经 阻滞 

分 类 号：R614.22[医药卫生—麻醉学]