不同剂量布托啡诺对罗哌卡因臂丛神经阻滞效果的影响  

Effect of different butorphanol dose on ropivacaine brachial plexus block

作　　者：孙昕培 韩雨佳 董沛娜 祁钰杰 徐赓 张凤萍 张倬宁 于剑锋[1] SUN Xinpei;HAN Yujia;DONG Peina;QI Yujie;XU Geng;ZHANG Fengping;ZHANG Zhuoning;YU Jianfeng(Department of Anesthesiology,Weifang Medical University,Weifang 261053,China;Department of Anesthesiology,Weifang Hospital of Traditional Chinese Medicine)

机构地区：[1]潍坊医学院麻醉学院,山东潍坊261053 [2]潍坊市中医院麻醉科

出　　处：《潍坊医学院学报》2021年第2期81-83,共3页Acta Academiae Medicinae Weifang

基　　金：国家自然科学基金资助课题(项目编号:81241041);山东省大学生创新创业训练计划项目资助课题(项目编号:S202010438071);潍坊医学院大学生科技创新基金项目资助课题(项目编号:KX2019082)。

摘　　要：目的初步探讨不同剂量布托啡诺超前镇痛对罗哌卡因臂丛神经阻滞的麻醉效果影响。方法选择拟行上肢手术的患者60例,ASAⅠ~Ⅱ级,随机分为4组(n=15),每组均采用0.375%罗哌卡因在超声引导下肌间沟臂丛神经阻滞麻醉,各组局麻药均不加肾上腺素。Con组(对照组):臂丛神经阻滞前注射曲马多100mg;B10组~B30组:臂丛神经阻滞前分别注射布托啡诺10μg/kg,20μg/kg,30μg/kg。观察术中患者血流动力学的变化;以患者术中追加咪达唑仑剂量或是否更改麻醉方式为指标进行术中麻醉满意程度评价;在术后2,4,8,12h和24h进行视觉模拟疼痛评分(VAS)评估术后疼痛程度。结果术后8h,12h时B10组、B20组和B30组VAS评分均明显低于Con组(P<0.05);术后12h时B20组VAS评分明显低于B10组(P<0.05),术后24h时B20组、B30组的VAS评分明显低于B10组和Con组(P<0.05)。结论采用中等浓度布托啡诺超前镇痛效果较好,可增强罗哌卡因对臂丛神经的阻滞效果,延长术后镇痛时间,同时降低不良反应发生率。Objective To investigate the effect of different dose of butorphanol on ropivacaine brachial plexus block.Methods Sixty ASAⅠ~Ⅱpatients with upper limb surgery under 0.375%ropivacaine ultrasound-guided interscalene brachial plexus block without epinephrine were randomly divided into four groups.In the group Con 100 mg tramadol was injected before brachial plexus block.From group B10 to group B30,10μg/kg,20μg/kg and 30μg/kg butorphanol tartrate were injected respectively before brachial plexus block.It was recorded the changes in hemodynamics,the evaluation of anesthesia satisfaction during operation by the additional dose of midazolam or changes in anesthesia,pain scores at 2,4,8,12 and 24 hours after operation and the incidence of dizziness and other adverse reactions.Results At 8 h and 12 h after operation,the VAS score of group Con was higher than the others significantly.At 12 h after operation,the VAS score of group B20 was lower than the group B10 significantly(P<0.05).At 24 h after operation,the pain score of group B20 and B30 was significantly lower than that of group B10 and Con.There was statistical significance that the incidence of dizziness in group B30 was significantly increased.Conclusion It has good preemptive analgesia effect of medium concentration butorphanol tartrate on ropivacaine brachial plexus block.It can enhance the effect of ropivacaine brachial plexus block,prolong the postoperative analgesia time with lower incidence of adverse reactions.

关 键 词：布托啡诺 超前镇痛 臂丛神经阻滞 

分 类 号：R614[医药卫生—麻醉学]