亚麻醉剂量艾司氯胺酮预处理对超声引导锁骨上臂丛神经阻滞效果的影响  

Effect of sub-anesthesia doses of esketamine pretreatment on ultrasound-guided supraclavicular brachial plexus block

作　　者：香效明 梁葵娣 冯书文 杨智学 林有梅 周小敏 邓爱娟 王慧玲 Xiang Xiaoming;Liang Kuidi;Feng Shuwen;Yang Zhixue;Lin Youmei;Zhou Xiaomin;Deng Aijuan;Wang Huiling(Department of Anesthesiology,Dongguan Hengli Hospital,Dongguan,Guangdong 523460,China)

机构地区：[1]横沥医院麻醉科,广东东莞523460

出　　处：《齐齐哈尔医学院学报》2023年第22期2149-2152,共4页Journal of Qiqihar Medical University

基　　金：东莞市社会科技发展(一般)项目(20211800901022)。

摘　　要：目的 拟探讨亚麻醉剂量艾司氯胺酮预处理对超声引导锁骨上臂丛神经阻滞效果的影响。方法 选择2021年4月—2023年4月本院收治的单侧上肢骨折患者60例作为研究对象,按照随机数表法分为实验组和对照组两组,每组各30例。实验组患者在接受超声引导锁骨上臂丛神经阻滞前20 min静脉注射艾司氯胺酮0.125 mg/kg,对照组患者则静脉注射等容量生理盐水。两组患者术中均实施超声引导锁骨上臂丛神经阻滞,术后行静脉自控镇痛。记录两组患者感觉阻滞起效时间、感觉阻滞维持时间;记录两组患者术后2、4、6、12、48 h疼痛VAS评分;记录两组患者术后首次按压镇痛泵时间、术后48 h内按压镇痛泵总次数和镇痛满意度;记录两组患者术后48 h内不良反应发生情况,如恶心呕吐、呼吸抑制、眩晕、高血压、心率增快等。结果 与对照组比较,实验组患者感觉阻滞起效时间明显缩短(P<0.05),感觉阻滞维持时间明显延长(P<0.05);与对照组比较,实验组患者术后6 h、12 h疼痛VAS评分明显降低(P<0.05);与对照组比较,实验组患者术后首次按压镇痛泵时间明显延长(P<0.05),术后48 h内按压镇痛泵总次数明显减少(P<0.05),镇痛满意度明显提高(P<0.05);两组患者术后48 h内均未发生恶心呕吐、呼吸抑制、眩晕、高血压、心率增快等不良反应。结论 亚麻醉剂量艾司氯胺酮静脉注射预处理能强化超声引导锁骨上臂丛神经阻滞麻醉镇痛效果,减少围术期镇痛药使用,提高患者满意度。Objective To investigate the effect of pretreatment with sub-anesthesia doses of esketamine on ultrasound-guided supraclavicular brachial plexus block.Methods Sixty patients with unilateral upper limb fractures who were admitted to our hospital from April 2021 to April 2023 were selected as study subjects.According to the number table method,they were randomly divided into an experimental group and a control group,with 30 patients in each group.The patients in experimental group received intravenous injection of esketamine at the dose of 0.125 mg/kg 20 minutes before receiving ultrasound guided supraclavicular brachial plexus block,while the patients in control group received intravenous injection of saline of equal volume.The onset time and maintenance time of sensory blockade were recorded in two groups of patients.The pain VAS scores of two groups were recorded at 2,4,6,12,and 48 hours after surgery.The time of the first postoperative application of the analgesic pump,the total times of the analgesic pump applied within 48 hours after surgery,and the satisfaction with analgesia were recorded for both groups of patients.Adverse reactions such as nausea,vomiting,respiratory depression,dizziness,hypertension,and increased heart rate in both groups of patients were recorded within 48 hours after surgery.Results Compared with the control group,the onset time of sensory block in the experimental group was significantly shortened(P<0.05),and the maintenance time of sensory block was significantly prolonged(P<0.05).Compared with the control group,the pain VAS score of patients in the experimental group significantly decreased at 6 and 12 hours after surgery(P<0.05).Compared with the control group,patients in the experimental group had a significantly longer time to press the analgesic pump for the first time after surgery(P<0.05),a significantly reduced total number of times to press the analgesic pump within 48 hours after surgery(P<0.05),and satisfaction with analgesia significantly improved(P<0.05).Both groups of p

关 键 词：亚麻醉剂量 艾司氯胺酮 预处理 锁骨上臂丛神经阻滞 镇痛 

分 类 号：R614[医药卫生—麻醉学]