高浓度罗帕卡因超声引导下肌间沟臂丛神经阻滞麻醉对上肢手术患者麻醉效果的影响  

Effect of High-concentration Ropivacaine Ultrasound-guided Intermuscu⁃lar Groove Brachial Plexus Nerve Block Anesthesia on Anesthesia Effect of Upper Extremity Surgery Patients

作　　者：徐成林[1] XU Chengin(Department of Anesthesiology,Guanyun County People's Hospital,Guanyun,Jiangsu Province,222200 China)

机构地区：[1]江苏省灌云县人民医院麻醉科,江苏灌云222200

出　　处：《系统医学》2023年第22期42-45,共4页Systems Medicine

摘　　要：目的 分析超声引导下、高浓度的罗帕卡因肌间沟臂丛神经阻滞麻醉(以下简称臂丛麻醉)对上肢手术的应用效果。方法 选取2020年1月—2023年3月江苏省灌云县人民医院收治的76例上肢骨折拟进行手术患者为研究对象,依照入院时间先后顺序分为参照组(n=25)、观察组(n=26)、研究组(n=25),罗哌卡因浓度依次为0.25%、0.35%、0.50%,对比3组麻醉应用情况。结果 研究组麻醉起效时间短于参照组和观察组,镇痛持续时间、术后麻醉苏醒时间均长于参照组和观察组,差异有统计学意义(P<0.05)。研究组尺神经、桡神经、肌皮神经的完全阻滞率均高于其他两组,差异有统计学意义(P<0.05)。3组患者的正中神经的完全阻滞率对比,差异无统计学意义(P>0.05)。参照组与观察组的各部位神经的完全阻滞率对比,差异无统计学意义(P>0.05)。3组患者麻醉相关不良反应发生率比较,差异无统计学意义(P>0.05)。结论 对上肢手术患者,采用0.50%的罗帕卡因、于超声引导下臂丛麻醉有更好的效果。Objective To analyze the application effect of ultrasound-guided,high-concentration ropivacaine interos-seous groove brachial plexus nerve block anesthesia(referred to as brachial plexus anesthesia)on upper extremity sur-gery.Methods A total of 76 patients with upper limb fractures admitted to Guanyun County People's Hospital of Ji-angsu Province from January 2020 to March 2023 were selected as the research objects.According to the order of ad-mission time,they were divided into reference group(n=25),observation group(n=26)and study group(n=25).The concentrations of ropivacaine were 0.25%,0.35%and 0.50%,respectively.The application of anesthesia in the three groups was compared.Results The onset time of anesthesia in the study group was shorter than that in the reference group and the observation group,and the duration of analgesia and postoperative anesthesia recovery time were longer than those in the reference group and the observation group,and the differences were statistically significant(P<0.05).The complete block rate of ulnar nerve,radial nerve and musculocutaneous nerve in the study group was higher than that in the other two groups,and the difference was statistically significant(P<0.05).There was no statistically signifi-cant difference in the complete block rate of median nerve among the three groups(P>0.05).There was no statistically significant difference in the complete block rate of nerves between the reference group and the observation group(P>0.05).There was no significant difference in the incidence of anesthesia-related adverse reactions among the three groups(P>0.05).Conclusion For patients with upper extremity surgery,the use of 0.50%ropivacaine,in ultrasound-guided brachial plexus anesthesia has better results.

关 键 词：高浓度罗帕卡因 超声 肌间沟 臂丛神经阻滞麻醉 上肢手术 

分 类 号：R614[医药卫生—麻醉学]