0.33%罗哌卡因行超声引导神经阻滞麻醉在跖趾关节矫形术的临床观察  

Clinical observation of ultrasound-guided nerve block anesthesia with 0.33%ropivacaine in metatarsophalangeal joint orthopaedic operation

作　　者：张志军[1] 郭辉[1] 贾若[1] 郑天源 高飞宇[1] 王蕾 段立鹏[2] 张鑫微 孙卫东 徐惠青[1] Zhang Zhijun;Guo Hui;Jia Ruo;Zheng Tianyuan;Gao Feiyu;Wang Lei;Duan Lipeng;Zhang Xinwei;Sun Weidong;Xu Huiqing(Department of Anesthesiology,Wangjing Hospital of China Academy of Chinese Medical Science,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院麻醉科,北京100102 [2]中国中医科学院望京医院中心手术室,北京100102 [3]中国中医科学院望京医院关节二科,北京100102

出　　处：《北京医学》2023年第7期578-583,共6页Beijing Medical Journal

基　　金：中国中医科学院望京医院自主选题专项(WJYYZZXT-2022-02)。

摘　　要：目的探讨超声引导下低浓度罗哌卡因行腘窝坐骨神经及隐神经阻滞麻醉在跖趾关节矫形术的效果。方法选取2021年10月至2022年4月中国中医科学院望京医院择期行跖趾关节矫形术的患者46例,采用随机、双盲法分为高浓度组(H组,20例)和低浓度组(L组,26例),H组采用0.5%罗哌卡因神经阻滞麻醉,L组采用0.33%罗哌卡因神经阻滞麻醉。两组均行超声引导下腘窝坐骨神经及隐神经阻滞,比较神经阻滞前后血流动力学指标、神经阻滞起效和维持时间、术中麻醉辅助用药情况、术后各时间点静态及动态疼痛程度的视觉模拟评分(visual analogue scale,VAS)及满意度。结果46例患者中男2例,女44例,年龄43~74岁,平均(60.2±7.6)岁。两组神经阻滞前后各时间点的MAP和HR,神经阻滞操作时间(t0)、感觉神经阻滞起效时间(t1)和完善时间(t2)、感觉神经阻滞维持时间(t3)、运动神经阻滞起效时间(t4)和维持时间(t5),术中麻醉辅助用药情况、术后各时间点疼痛的静态及动态VAS评分和患者满意度的比较,差异均无统计学意义(P>0.05)。结论0.33%罗哌卡因用于超声引导神经阻滞麻醉能够满足跖趾关节矫形手术的需要。Objective To explore the effect of ultrasond-guided low concentration ropivacaine in popliteal sciatic nerve and saphenous nerve block anesthesia in metatarsophalangeal joint orthopedics.Methods A total of 46 patients who underwent metatarsophalangeal joint orthopedic surgery in Wangjing Hospital of China Academy of Chinese Medical Sciences from October 2021 to April 2022 were selected,and were randomly divided into high concentration group(group H,20 cases)and low concentration group(group L,26 cases).Group H received 0.5%ropivacaine nerve block anesthesia,and group L received 0.33%ropivacaine nerve block anesthesia.Ultrasound-guided popliteal sciatic nerve and saphenous nerve block were performed in both groups.The hemodynamic indicators before and after nerve block,anesthesia effect of nerve block,intraoperative anesthesia adjuvant drugs,static and dynamic visual analogue score(VAS)and satisfaction of pain at each time point after surgery were compared.Results Among the 46 patients,there were two males and 44 females,aged from 43 to 74 years,with an average age of(60.2±7.6)years.There were no significant differences in MAP and HR before and after nerve block,nerve block operation time(to),sensory nerve block onset time(t),sensory nerve block completion time(t),sensory nerve block maintenance time(t),motor nerve block onset time(t),motor nerve block maintenance time(t),intraoperative anesthetic adjuvant drugs,VAS score of static and dynamic pain at each time point and patient satisfaction between the two groups(P>0.05).Conclutions Ultrasound-guided nerve block anesthesia with 0.33%ropivacaine can meet the needs of metatarsophalangeal joint orthopaedic surgery.

关 键 词：罗哌卡因 超声引导 腘窝坐骨神经阻滞 隐神经阻滞 跖趾关节矫形术 

分 类 号：R614[医药卫生—麻醉学]