地塞米松10mg复合地佐辛对肌间沟臂丛神经阻滞效果的影响  

Influence of dexamethasone combined with dezocine on interscalene brachial plexus block

作　　者：郑颖梅[1] 陈栋[1] 丁燕群[1] 

机构地区：[1]江苏省常州市第二人民医院麻醉科,213003

出　　处：《临床麻醉学杂志》2013年第12期1190-1192,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察地塞米松10mg复合地佐辛对肌间沟臂丛神经阻滞效果的影响。方法在肌间沟臂丛神经阻滞下行上肢骨折手术患者90例,随机分为三组,其中C组给予0.375%罗哌卡因,D组给予0.375%罗哌卡因+地佐辛0.05mg/kg,DD组给予0.375%罗哌卡因+地佐辛0.05mg/kg+地塞米松10mg,药液均为20ml。记录感觉阻滞起效时间、阻滞持续时间、镇痛持续时间,以及术后4、12、24h的疼痛VAS评分。观察不良反应情况。结果 D组和DD组感觉阻滞起效时间明显短于C组(P<0.05),阻滞持续时间和镇痛持续时间明显长于C组(P<0.05)。DD组阻滞持续时间和镇痛持续时间明显长于D组(P<0.05)。DD组恶心呕吐发生率明显低于D组(P<0.05)。术后4、12、24h,D组和DD组疼痛VAS评分明显低于C组(P<0.05)。术后12、24h,DD组VAS评分显著低于D组(P<0.05)。结论地塞米松10mg复合地佐辛可以改善肌间沟臂丛神经阻滞效果,增强术后镇痛,减少不良反应。Objective To observe the dexamethasone combined with dezocine on interscalene brachial plexus block. Methods Ninety cases ASA I or II patiens scheduled for upper extemity surgery with interscalene brachia[ plexus block were randomly divided into three groups, with 30 cases in each group. Control group （group C） was given 0. 375% ropivacaine 20 ml Dizuoxin group （group D） was received 0. 375% ropivacaine＋ 0.05 mg/kg dezocine 20 ml; dexamethasone combined with dezocine group （group DD） was injected with 0. 375% ropivacaine ＋ 0. 05 mg/kg dezocine and dexamethasone 10 mg 20 ml. Sensory block onset time, sensory block continuous time, and duration of analgesia were recorded in three groups. Anesthetic effect and dizziness, nausea, vomiting, skin itching were observed in three groups. VAS score was compared in three groups at 4 h, 12 h, 24 h postoperatively. Results Sensory block onset time in group D and group DD were significantly shorter than that in group C （P〈0.05）, sensory block continuous time and duration of analgesia were significantly longer than those in group C（P〈0.05）. Sensory block continuous time and duration of analgesia in group DD were significantly longer than those in group D（P〈0.05）. Anesthetic effect of group D and DD were significantly better than that in group C（P〈0.05）. The incidence of nausea and vomiting in group DD was significantly lower than that in group D（P〈0. 05）. VAS scores in group D and DD were significantly lower than those in group C（P〈0. 05）at 4 h, 12 h, 24 h postoperatively. VAS score at postoperative 12 h, 24 h in group DD were significantly lower than those in group D（P〈0. 05）. Conclusion Dexamethasone combined with dezocine improved analgesic effect of interscalene brachial plexus block,enhanced the postoperative analgesia and reduced adverse reactions.

关 键 词：地塞米松 地佐辛 肌间沟臂丛神经阻滞 

分 类 号：R614[医药卫生—麻醉学]