超声引导下地佐辛复合地塞米松对腋路臂丛神经阻滞效果评价  

Effect of dezocine combined with dexamethasone on brachial plexus block under the guidance of ultrasound

作　　者：张晓侠[1] 聂明辉[1] 刘新伟[1] 王志学[1] 董龙[1] 李汝泓[1] 于铁莉[1] 

机构地区：[1]承德医学院附属医院,河北承德067000

出　　处：《中国地方病防治》2017年第2期194-195,共2页Chinese Journal of Control of Endemic Diseases

基　　金：承德市科学技术研究与发展计划项目(201601A038)

摘　　要：目的探讨经超声引导下的地佐辛复合地塞米松对腋路臂丛神经的阻滞效果。方法选取2014年9月至2016年2月在本院行腋路臂丛神经麻醉下前臂手术的患者110例,按照随机数表法,所有患者被随机分为观察组和对照组,每组各55例。对照组患者采用0.67%利多卡因+0.5%罗哌卡因麻醉,观察组患者0.67%利多卡因+0.5%罗哌卡因+地塞米松10 mg+地佐辛0.1 mg/Kg麻醉,两组药液量均为30 ml。比较两组患者麻醉效果、术后不同时间点VAS评分,不良发应发生情况以及患者对麻醉的满意度。结果观察组患者麻醉起效时间、阻滞完全时间、麻醉持续时间均明显长于对照组(P<0.05),且观察组患者术后8、12、24、48 h VAS评分均显著低于对照组(P<0.05)。观察组患者恶心呕吐、皮肤瘙痒、头晕发生率等不良反应的发生率亦明显低于对照组(P<0.05)。观察组患者的麻醉满意度评分明显高于对照组(P<0.05)。结论经超声引导的地佐辛复合地塞米松混合常规局麻药物用于臂丛神经阻滞可以显著增强麻醉效果、延长麻醉时间,同时不良反应发生率较低,相较于一般麻醉方法优势显著。Objective To research the effect of dezocine combined with dexamethasone on brachial plexus block under the guidance of ultrasound.Methods A total of 110 cases with forearm surgery under axillary brachial plexus anesthesia in our hospital from September 2014 to February 2016 were researched. All patients were randomly divided into observation group and control group according to the random number table method,each 55 cases. The control group were anestheticted with 0.67% lidocaine ＋ 0.5%ropivacaine.The volume of the solution was 30 ml.The observation group were anestheticted with 0.67% lidocaine ＋0.5% ropivacaine＋ dexamethasone 10mg＋ dezocine anesthesia 0.1mg/Kg. The volume of the solution was also 30 ml.Compared their anesthesia effect,the different time point visual analog score（ VAS）,the incidence of adverse reactions and patient satisfaction with anesthesia of the two groups.Results In the observation group,the onset time of anesthesia,the time of complete anesthesia,duration of anesthesia were significantly longer than those of the control group（ P 〈 0.05）. The 8h,12 h,24h,48 h VAS scores of the observation group were significantly lower than those of the control group（ P 〈 0.05）. Theadverse reactions incidence of nausea,vomiting,pruritus,dizziness in the observation group were significantly lower than those in the control group（ P〈0.05）.The anaesthesia satisfaction degree of the patients in the observation group was significantly higher than that of the control group（ P〈0.05）.Conclusion Dezocine combined with dexamethasone can significantly enhanced brachial plexus block effect,it can prolong the duration of anesthesia,and reduce incidence of adverse reactions.It has more advantages than general anesthesia method.

关 键 词：超声 地佐辛 地塞米松 臂丛神经 

分 类 号：R445[医药卫生—影像医学与核医学]