超声引导下小儿臂丛神经阻滞局麻药物最佳剂量分析  

Analysing optimal dose of pediatric brachial plexus anesthesia under ultrasound

作　　者：伍捡林[1] 刘安林[1] 黄波[1] 伍捡雄 陈明富[1] 

机构地区：[1]广州医科大学附属深圳沙井医院麻醉科,广东深圳518104

出　　处：《局解手术学杂志》2015年第4期406-408,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨超声引导下小儿腋路臂丛神经分支阻滞的最佳麻醉药物剂量。方法选择2012年5月至2013年5月我院手外科6~12岁的48例患儿作为研究对象,随机将其分为4组,每组各12例,罗哌卡因剂量分别为A组0.25 m L/kg、B组0.2 m L/kg、C组0.15 m L/kg、D组0.10 m L/kg,术中根据麻醉情况追加氯胺酮。根据神经阻滞情况评价麻醉效果,观察麻醉持续时间、全麻药物用量及并发症发生率。结果 A、B、C组阻滞30 min后各神经支配区阻滞效果相当,均比D组的麻醉有效率高、追加率低,差异均有统计学意义（P〈0.05）,D组的阻滞时间短于其他各组,氯胺酮追加最多,且阻滞起效、完善时间均长于其他3组（P〈0.05）,A、B、C组间差异无统计学意义。D组有2例转为全麻。4组均未发生麻醉药物相关并发症。结论超声引导下罗哌卡因用于小儿臂丛神经阻滞分支阻滞完善,麻醉效果确切,药用量为0.15 m L/kg即可取得较好的麻醉效果。Objective To investigate optimum dose of anesthesia in pediatric axillary brachial plexus branch block under ultrasoundguided. Methods Forty-eight children from May 2012 to May 2013 in hand surgery of our hospital,whose age was from 6 to 12 years,were randomly divided into four groups,each group has 12 cases. The doses of Ropivacaine were different in different groups. Group A was0. 25 m L / kg,group B was 0. 2 m L / kg,group C was 0. 15 m L / kg,group D was 0. 10 m L / kg. And Ketamine was added to the treatment according to the incidence of anesthesia intraoperative. Evaluating the effect of anesthesia according to the situation of nerve block,observing anesthesia duration time,dosage of anesthesia and rates of complications. Results The blocking effect of group A,B and C in each nerve area was correspond after 30 min,and anesthesia efficiency was higher than group D,but additional rate was lower than group D,the differences were statistically significant（ P 〈0. 05）. The block time in group D was shorter than the other groups,and the dose of Ketamine was most,and the block onset,perfect time were longer than the other groups（ P 〈0. 05）. But the differences between group A,B,C were not significant. Two cases in group D converted to general anesthesia. Four groups did not occur complication related narcotic drug. Conclusion In pediatric brachial plexus block used Ropivacaine under ultrasound-guided would get complete branch block,the exact effect of anesthesia,smaller dosage of local anesthesia. When the dosage of Ropivacaine was 0. 15 m L / kg could achieve a better anesthesia effect.

关 键 词：罗哌卡因 臂丛神经分支 神经阻滞 

分 类 号：R614.3[医药卫生—麻醉学]