不同剂量地塞米松复合罗哌卡因神经阻滞对罗哌卡因阻滞时效的影响  

Effect of Different Doses of Dexamethasone Compounded with Ropivacaine Nerve Block on the Time Limit of Ropivacaine Block

作　　者：陈梅花[1] 赵以松[1] CHEN Meihua;ZHAO Yisong(Department of Anesthesiology,Suzhou Hospital of Traditional Chinese Medicine,Suzhou,Jiangsu Province,215000 China)

机构地区：[1]苏州市中医医院麻醉科,江苏苏州215000

出　　处：《世界复合医学》2023年第7期188-191,共4页World Journal of Complex Medicine

摘　　要：目的 分析不同剂量(5 mg、10 mg)地塞米松复合罗哌卡因神经阻滞对罗哌卡因阻滞时效的影响。方法 选取2022年1—8月苏州市中医医院收治的桡骨骨折患者80例,使用抛硬币方式分成对照组,观察组,对照组(n=40)采取低剂量(5 mg)地塞米松复合罗哌卡因,观察组(n=40)采取高剂量(10 mg)地塞米松复合罗哌卡因,统计阻滞时效,分析麻醉用量,并对不良反应进行统计。结果 观察组感觉及运动起效时间短于对照组,而阻滞持续时间则较长于对照组,差异有统计学意义(P<0.05);观察组病人自控阵痛泵(patient controlled analgesia, PCA)按压次数和有效次数、芬太尼用量低于对照组,差异有统计学意义(P<0.05);观察组与对照组在不良反应方面的数据均比较低,差异无统计学意义(P>0.05);术后12、24 h观察组疼痛评分(0.45±0.11)分、(1.03±0.12)分显著低于对照组,差异有统计学意义(t=28.226、19.425,P<0.05),但术后36、48 h两组比较,差异无统计学意义(P>0.05)。结论 5 mg和10 mg地塞米松复合罗哌卡因的神经阻滞效果比较,10 mg剂量下阻滞起效更快,且持续时间更长,而且减少了芬太尼的用量,不良反应少,减轻了术后疼痛,是一种安全有效的麻醉剂量。Objective To analyze the effect of different doses(5 mg,10 mg)of dexamethasone compounded with ropivacaine nerve block on the time limit of ropivacaine block.Methods A total of 80 radial fracture patients admitted to Suzhou Hospital of Traditional Chinese Medicine from January August 2022 enrolled patients,and divided into the control group and the observation group using a coin toss.The control group(n=40)took low dose(5 mg)dexamethasone compounded with ropivacaine,and the observation group(n=40)took high dose(10 mg)dexamethasone compounded with ropivacaine.The block duration was counted,the anesthetic dosage was analyzed,and the adverse effects were counted.Results The onset time of sensory and motor duration in the observation was shorter than the control group,while the block time duration was longer than the control group,and the difference was statistically significant(P<0.05).The presses times and effective times of patient controlled analgesia(PCA)pump,and fentanyl dosage in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The adverse reactions data in the observation group and the control group were all lower,and the difference was not statistically significant(P>0.05).Pain scores of postoperative 12 h and 24 h in the observation group(0.45±0.11)points,(1.03±0.12)points were significantly lower than those in the control group,and the difference was statistically significant(t=28.226,19.425,P<0.05),but the difference was not statistically significant in the postoperative 36 h and 48 h(P>0.05).Conclusion The nerve block effect of 5mg and 10mg dexamethasone compounded with ropivacaine was compared,and the block onset was faster and lasted longer at the dose of 10mg,and the dosage of fentanyl was reduced,with fewer adverse reactions and reduced postoperative pain,which is a safe and effective anesthetic dose,and is recommended to be promoted in the clinic.

关 键 词：地塞米松 罗哌卡因 神经阻滞对 阻滞时效 疼痛控制 安全性 

分 类 号：R742[医药卫生—神经病学与精神病学]