不同剂量罗哌卡因在B超引导下C5横突联合颈浅丛阻滞用于锁骨骨折手术的对比研究  

A Comparative Study of Different Doses of Ropivacaine Combined with Superficial Cervical Plexus Block Guided by B-mode Ultrasonography in Clavicular Fracture Surgery

作　　者：彭丹丹[1] 李贝[1] 仇雪群 黄晓媚[1] 谢林碧[1] 黄伟文[1] PENG Dandan;LI Bei;QIU Xuequn;HUANG Xiaomei;XIE Linbi;HUANG Weiwen(Department of Anesthesiology,People's Hospital of Gaoming District,Foshan City,Foshan,Guangdong 528500,China)

机构地区：[1]佛山市高明区人民医院麻醉科,广东佛山528500

出　　处：《今日药学》2022年第4期310-313,共4页Pharmacy Today

基　　金：佛山市卫生和计生局医学科研课题(20190429)。

摘　　要：目的 探讨不同剂量罗哌卡因在B超引导下C5横突联合颈浅丛阻滞用于锁骨骨折手术中的麻醉效果。方法 纳入90例择期或急诊进行锁骨骨折切开复位内固定或锁骨骨折内固定术后内固定拆除手术的患者,ASAⅠ~Ⅱ级,分为A、B、C 3组,每组患者30例。通过B超定位,确定C5横突位置,在C5神经根前支周围分别注射0.375%罗哌卡因15,11,7 mL,退针至皮下,再进针至胸锁乳突肌上缘外侧,颈浅筋膜深层注射0.375%罗哌卡因5 mL。本研究的主要观察指标包括阻滞完成时间,麻醉起效时间,维持时间,麻醉效果观察,麻醉相关并发症。结果 本研究结果显示3组麻醉阻滞完成时间差异无统计学意义(P>0.05),麻醉起效时间C组较慢(P<0.05),A、B组差异无统计学意义(P>0.05)。维持时间A组最长,C组最短,A、B组均能满足手术需要,C组有2例患者改为全麻手术。麻醉效果A、B组明显优于C组,但A组出现的麻醉相关并发症较B、C组增多。结论 B超引导下C5横突联合颈浅丛阻滞用于锁骨手术时使用不同剂量罗哌卡因均可完成手术,但11 mL组的麻醉效果更好,并发症的发生率更低。OBJECTIVE To investigate the anesthetic effect of different doses of ropivacaine in C5 transverse process combined with superficial cervical plexus block under the guidance of B-ultrasound in the operation of clavicular fracture. METHODS 90 patients underwent open reduction and internal fixation of clavicular fracture or removal of internal fixation after internal fixation of clavicular fracture, ASAⅠ-Ⅱ,who were randomly divided into groups A, B and C(n=30). The location of C5 transverse process was determined by B-ultrasound. The three groups around the anterior branch of C5 nerve root were injected by 0.375% ropivacaine 15, 11, 7 mL respectively. The needle was withdrawn to the subcutaneous area, then 0.375% ropivacaine was injected into the superficial cervical plexus for 5 mL. The main observation indexes of this study included the completion time of block, the onset time of anesthesia, the maintenance time, the observation of anesthesia effect, and anesthesia related complications. RESULTS The results showed that there was no significant difference in the completion time of anesthesia block between group A, B and C(P>0.05). The onset time of anesthesia was slow in group C(P<0.05). There was no significant difference between group A and group B(P>0.05). The duration of anesthesia was the longest in group A and the shortest in group C. The anesthesia effect of group A and B were better than that of group C. However, the incidence of anesthesia-related complications in group A was higher than that in group B and C. CONCLUSION Ultrasound-guided C5 transverse process block combined with superficial cervical plexus block for clavicular surgery can be performed with different doses of ropivacaine, but the anesthesia effect of 11 ml group is better and the incidence of complications is lower.

关 键 词：超声 C5横突 锁骨骨折 颈浅丛 罗哌卡因 

分 类 号：R969[医药卫生—药理学]