舒芬太尼复合地塞米松在臂丛神经阻滞中的麻醉效果分析  

Analysis of Anesthetic Effect of Sufentanil Combined with Dexamethasone in Brachial Plexus Block

作　　者：唐上志 覃英[1] 黄芳莲 黄丽萍 TANG Shangzhi;QIN Ying;HUANG Fanglian;HUANG Liping(Department of Anesthesiology,the Affiliated Hospital of Guangxi Youjiang Ethnic Medical College,Baise,Guangxi Zhuang Autonomous Region,533000 China;Department of Anesthesiology,Baidong Branch of the Affiliated Hospi-tal of Guangxi Youjiang Ethnic Medical College,Baise,Guangxi Zhuang Autonomous Region,533000 China)

机构地区：[1]广西右江民族医学院附属医院麻醉科,广西百色533000 [2]广西右江民族医学院附属医院百东院区麻醉科,广西百色533000

出　　处：《中外医疗》2023年第22期110-114,共5页China & Foreign Medical Treatment

基　　金：百色市科学研究与技术开发计划课题(百科20212304)。

摘　　要：目的分析在臂丛神经阻滞中用舒芬太尼复合地塞米松的麻醉效果。方法回顾性分析2021年1月—2022年12月广西右江民族医学院附属医院百东院区麻醉科收治的上肢骨折手术患者100例的临床资料,按照麻醉方法不同,分为0.5%罗哌卡因20 mL(A组);0.5%罗哌卡因+舒芬太尼0.20μg/kg混合液20 mL(B组);0.5%罗哌卡因+地塞米松0.15 mg/kg混合液20 mL(C组);0.5%罗哌卡因+地塞米松0.15 mg/kg+舒芬太尼0.20μg/kg混合液20 mL(D组),每组25例,记录4组患者神经阻滞后感觉、运动阻滞完全和持续时间、首次使用镇静药物时间、术后12、24、48 h镇痛泵使用量、术后6、12、24、48 h视觉模拟疼痛评分(Visual Ana-logue Scale,VAS)及不良反应发生率。结果D组患者神经阻滞后感觉(6.85±0.13)h、运动阻滞完全时间(5.03±0.24)h和持续时间(11.26±0.11)h均长于A、B、C组,且A组各项指标与B、C组对比,差异有统计学意义(P<0.05),但B、C组各项指标比较,差异无统计学意义(P>0.05)。D组患者术后12、24、48 h镇痛泵使用量低于A、B、C组,首次使用镇静药物时间长于于A、B、C组,且A组各项指标与B、C组对比,差异有统计学意义(P<0.05),但B、C组各项指标比较,差异无统计学意义(P>0.05)。D组患者术后6、12、24、48 h的VAS评分低于A、B、C组,且A组与B、C组对比,差异有统计学意义(P<0.05),但B、C组各项指标比较,差异无统计学意义(P>0.05)。4组不良反应比较,差异无统计学意义(P>0.05)。结论臂丛神经阻滞中,在罗哌卡因麻醉的基础上,采取舒芬太尼复合地塞米松麻醉可明显提高其麻醉效果,降低术后疼痛程度,延长麻醉阻滞时间,且不会增加不良反应发生率。Objective To analyze the anesthetic effect of sufentanil combined with dexamethasone in brachial plexus block.Methods Retrospective analysis of clinical data of 100 patients with upper limb fracture surgery admitted to the Anesthesiology Department of Baidong Hospital,Affiliated Hospital of Guangxi Youjiang Medical College for Nation-alities from January 2021 to December 2022 was conducted.According to different anesthesia methods,they were di-vided into 20 mL of 0.5%ropivacaine(group A);0.5%ropivacaine+sufentanil 0.20μg/kg mixture 20 mL(group B);20 mL of 0.5%ropivacaine+dexamethasone 0.15 mg/kg mixture 20 mL(group C);0.5%ropivacaine+dexamethasone 0.15 mg/kg+sufentanil 0.20μg/kg mixture 20 mL(group D),25 patients in each group,recorded the complete and du-ration of sensory and motor block after nerve block,the time of first use of sedative drugs,the amount of analgesic pump used at 12,24,and 48 hours after surgery,the Visual Analogue Scale(VAS)at 6 hours,12 hours,24 hours,and 48 hours after surgery,and the incidence of adverse reactions.Results Group D patients had longer sensory(6.85±0.13)hours,complete motor block time(5.03±0.24)hours,and duration(11.26±0.11)hours after nerve block com-pared to group A,B,and C.The difference in various indicators between group A and group B and C was statistically significant(P<0.05),but the difference in various indicators between group B and C was not statistically significant(P>0.05).The use of analgesic pumps in group D patients was lower than that in groups A,B,and C at 12 hours,24 hours,and 48 hours after surgery,and the first use of sedative drugs was longer than that in groups A,B,and C.The difference in various indicators between group A and groups B and C was statistically significant(P<0.05),but there was no statistically significant difference in various indicators between groups B and C(P>0.05).The VAS scores of patients in group D at 6 hours,12 hours,24 hours,and 48 hours after surgery were lower than those in groups A,B,and C.There was a statistically signif

关 键 词：舒芬太尼 地塞米松 臂丛神经阻滞 麻醉 

分 类 号：R614[医药卫生—麻醉学]