超声引导下不同浓度甲磺酸罗哌卡因臂丛神经阻滞麻醉对麻醉效果及术后恢复的影响  

Effect of Ultrasound-guided brachial Plexus Block Anesthesia with Different Concentrations of Ropivacaine Mesylate on Anesthesia and Postoperative Recovery

作　　者：王慧慧 张燕岭 WANG Huihui;ZHANG Yanling(Department of Anesthesiology,Jiaxiang County People's Hospital,Jining,Shandong Province,272400 China)

机构地区：[1]嘉祥县人民医院麻醉科,山东济宁272400

出　　处：《系统医学》2022年第17期84-87,共4页Systems Medicine

摘　　要：目的探讨超声引导下采用不同浓度甲磺酸罗哌卡因臂丛神经阻滞麻醉时对麻醉效果以及患者术后恢复的影响。方法选择嘉祥县人民医院2021年1-10月收治的上肢手术患者100例,按照随机数表法分为0.31%甲磺酸罗哌卡因麻醉观察组(n=50)与采用0.495%甲磺酸罗哌卡因麻醉对照组(n=50),比较两组麻醉效果,并对两组患者不良反应进行分析。结果观察组尺神经、桡神经、肌皮神经以及正中神经完全阻滞率分别为76.00%、82.00%、82.00%、78.00%,均低于对照组94.00%、96.00%、98.00%、94.00%,差异有统计学意义(χ^(2)=6.353、5.005、7.111、5.316,P<0.05)。两组麻醉优良率(94.00%vs 98.00%)差异无统计学意义(χ^(2)=0.260,P>0.05)。观察组麻醉起效时间(16.25±3.57)min长于对照组;镇痛持续时间、运动阻滞恢复分别为(7.24±2.62)h、(7.28±2.15)h,短于对照组,差异有统计学意义(t=5.219、2.515、3.085,P<0.05)。观察组不良反应发生率低于对照组(6.00%vs 20.00%),差异有统计学意义(χ^(2)=4.332,P<0.05)。结论采用0.31%甲磺酸罗哌卡因进行超声引导下臂丛神经阻滞麻醉,虽然阻滞完全率低于0.495%甲磺酸浓度,麻醉起效时间更长,但两种浓度均可起到较好的麻醉效果,低浓度麻醉患者术后恢复更快且不良反应风险更低。Objective To investigate the effect of ultrasound-guided brachial plexus block anesthesia with different concentrations of ropivacaine mesylate on the anesthesia effect and postoperative recovery of patients.Methods A total of 100 patients with upper limb surgery were selected from Jiaxiang County People's Hospital from January to October 2021.According to the random number table method,they were divided into 0.31%ropivacaine mesylate anesthesia observation group(n=50)and 0.495%ropivacaine mesylate anesthesia control group(n=50).The anesthesia effects of the two groups were compared,and the adverse reactions of the two groups were analyzed.Results The complete block rates of the ulnar nerve,radial nerve,musculocutaneous nerve and median nerve in the observation group were 76.00%,82.00%,82.00%and 78.00%were lower than the control group by 94.00%,96.00%,98.00%and 94.00%,the difference was statistically significant(χ^(2)=6.353,5.005,7.111,5.316,P<0.05).There was no statistically significant difference in the excellent and good rate of anesthesia between the two groups(94.00%vs 98.00%)(χ^(2)=0.260,P>0.05).The onset time of anesthesia in the observation group was(16.25±3.57)min,which was longer than that in the control group.The duration of analgesia and the recovery of motor block were(7.24±2.62)h and(7.28±2.15)h,respectively,shorter than those in the control group,the difference was statistically significant(t=5.219,2.515,3.085,P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(6.00%vs 20.00%),the difference was statistically significant(χ^(2)=4.332,P<0.05).Conclusion Using 0.31%ropivacaine mesylate for ultrasound-guided brachial plexus block anesthesia,although the complete block rate is lower than 0.495%mesylate concentration,the onset time of anesthesia is longer.However,both concentrations can have better anesthesia effect,and patients with low concentration anesthesia have faster postoperative recovery and lower risk of adverse reactions.

关 键 词：甲磺酸罗哌卡因 不同浓度 超声引导 神经阻滞麻醉 不良反应 

分 类 号：R4[医药卫生—临床医学]