不同温度罗哌卡因溶液对锁骨下臂丛神经阻滞的影响  

Effects of ropivacaine solution at different temperatures on infraclavicular brachial plexus block

作　　者：颜欣 邵昊舫 何玉莲 毛晟 YAN Xin;SHAO Haofang;HE Yulian(Department of Anesthesiology,Ningbo Medical Center Lihuili Hospital,Ningbo 315048,CHINA)

机构地区：[1]宁波市医疗中心李惠利医院麻醉科,浙江315048 [2]宁波市鄞州区第二医院麻醉科

出　　处：《江苏医药》2023年第4期409-411,共3页Jiangsu Medical Journal

摘　　要：目的 观察不同温度罗哌卡因溶液对超声引导下锁骨下臂丛神经阻滞(BPB)的影响。方法 前臂骨科手术患者100例随机分为H组和L组,每组50例。两组均在B超引导下行锁骨下BPB:H组分次注射37℃的0.4%罗哌卡因30 mL;L组分次注射23℃的0.4%罗哌卡因30 mL。记录两组患者感觉、运动神经阻滞起效时间及阻滞持续时间,术后1、3、6、12和24 h行VAS疼痛评分,记录术后镇痛药物首次使用时间及追加次数,观察相关并发症的发生情况。结果 与L组相比,H组患者运动、感觉神经阻滞起效时间快,阻滞持续时间长,术后6、12及24 h的VAS疼痛评分低,术后首次镇痛药物使用时间晚,镇痛药物追加次数少(P<0.05)。所有患者未出现锁骨下BPB相关并发症。结论 锁骨下BPB时,加温的罗哌卡因溶液可缩短阻滞起效时间,延长阻滞持续时间,减少术后镇痛药物的应用。Objective To observe the effects of ropivacaine solution at different temperatures on infraclavicular brachial plexus block(BPB).Methods One hundred patients undergoing forearm orthopedic surgery were randomly divided into two groups with 50cases each.Infraclavicular BPB guided by B-ultrasound was performed with 0.4%ropivacaine 30mL at 37℃(group H)or 0.4%ropivacaine 30mL at 23℃(group L).The onset time and duration of sensory and motor nerve blockade,and VAS pain scores at the time points of 1hour,3hours,6hours,12hours and 24hours after operation were recorded.The first time to use additional postoperative analgesics and the times of its use were recorded as well.The BPB-related complications were observed.Results Compared with group L,the patients in group H had faster onset and longer duration of motor and sensory nerve blockade(P<0.05).The VAS pain scores at 6hours,12hours and 24hours after operation were lower in group H than those in group L(P<0.05).Compared with group L,the first time to use additional postoperative analgesics was later and the times of its use was less(P<0.05).No BPBrelated complications occurred in all patients.Conclusion For infraclavicular BPB,warmed ropivacaine solution can shorten the onset time of blockade,prolong the duration of blockade,and reduce the use of postoperative analgesics.

关 键 词：温度 罗哌卡因 臂丛神经阻滞 超声 

分 类 号：R614[医药卫生—麻醉学]