布托啡诺对罗哌卡因肌间沟臂丛神经阻滞的影响  

Effects of butorphanol combined with ropivacaine on interscalene brachial plexus block

作　　者：刘才堂[1] 陈剑[1] 

机构地区：[1]中山大学附属东华医院麻醉科,广东省东莞市523110

出　　处：《中国医药》2011年第9期1113-1114,共2页China Medicine

摘　　要：目的 观察罗哌卡因复合布托啡诺用于肌间沟臂丛神经阻滞的效果.方法 选择60例行上肢手术成人患者,完全随机分为2组,每组30例.均行肌间沟臂丛神经阻滞,对照组用0.33%罗哌卡因30ml,研究组用0.33%罗哌卡因30ml＋布托啡诺1 mg.2组均记录术中15、30、60min和术后4、8、12、24 h各时间点的疼痛评分[采用视觉模拟评分法（VAS）],记录麻醉起效时间、持续时间、不良反应发生率,并进行比较.结果 感觉和运动神经阻滞起效时间研究组[（2.1±1.3）、（8.0±2.2）min]比对照组[（5.3±2.1）、（15.0±3.3）min]明显加快,镇痛持续时间研究组[（714.4±95.4）min]比对照组[（510.7±99.8）min]明显延长（P＜0.05;术中15、30、60min,术后4、8、12、24h各时间点VAS评分研究组[（1.1±0.6）、（1.3±0.6）、（1.3±0.5）、（2.4±1.1）、（3.0±1.0）、（4.1±1.1）、（4.2±1.7）分]明显低于对照组[（1.7±0.7）、（1.6±0.5）、（3.1±0.3）、（6.1±1.5）、（6.8±1.7）、（7.0±2.1）、（6.0±1.1）分]（P＜0.05）.结论 0.33%罗哌卡因复合布托啡诺用于肌间沟臂丛神经阻滞能使感觉和运动神经阻滞起效时间缩短,镇痛时间明显延长,镇痛效果明显增强,但不延长运动阻滞时间.Objective To observe the effects of butorphanol combined with ropivacaine on interscalene brachial plexus block. Methods Sixty adult patients （ASA Ⅰ - Ⅱ） undergoing upper extremity surgery under interscalene brachial plexus block were randomly divided into two groups. Patients in control group（n = 30）were administered with 25 ml of 0.4% ropivacaine and study group（n =30）were administered with 25 ml of 0.4% ropivacaine with butorphanol 1 mg. Visual analogue scale（VAS） scores were recorded at 15, 30, 60 min after local anesthetic infusion and 4, 8, 12, 24 h after operation. The onset time of both sensory and motor block, the duration time of nerve blockage and side effects were recorded. Results The onset of sensory and motor block in study group [（2. 1 ± 1.3）, （8.0 ± 2.2） min] was significantly faster than that in control group [（5.3 ± 2. 1）, （15.0 ± 3.3） min]（P 〈 0.05）. The duration of the analgesia was prolonged significantly. However, the duration of motor block did not differ between the groups. The scores of VAS during operation and after operation in study group [（1.1 ± 0.6）,（1.3 ±0.6）,（1.3±0.5）,（2.4 ±1.1）,（3.0 ± 1.0） ,（4.1 ± 1.1）,（4.2 ± 1.7）] were significantly lower than those in control group [（1.7 ±0.7）,（1.6 ±0.5） ,（3,. 1 ±0.3）,（6.1 ±1.5）,（6.8 ± 1.7）,（7.0 ±2.1） ,（6.0 ±1.1）] （P 〈 0.05）. Conclusions Butorphanol （1 mg） in combination with 30 ml （0.33 %） ropivacaine enhance onset of sensory and motor block and prolonged duration of the analgesia. Aalgesia is enhanced when brachial plexus block is used without prolonged duration of motor block.

关 键 词：布托啡诺 臂丛神经阻滞 罗哌卡因 上肢手术 

分 类 号：R971[医药卫生—药品]