艾司氯胺酮复合罗哌卡因在腋路臂丛神经阻滞中的应用效果  

Application effects of Esketamine combined with Ropivacaine in axillary brachial plexus block anesthesia

作　　者：孙晓伟 SUN Xiaowei(Department of Anesthesiology of Jia County Hospital of Traditional Chinese Medicine,Pingdingshan 467100 Henan,China)

机构地区：[1]郏县中医院麻醉科,河南平顶山467100

出　　处：《中国民康医学》2024年第17期68-71,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察艾司氯胺酮复合罗哌卡因在腋路臂丛神经阻滞中的应用效果。方法:回顾性分析2022年3月至2023年3月于该院接受腋路臂丛神经阻滞的76例手外伤患者的临床资料,根据麻醉方案不同将其分为对照组和研究组各38例。两组均行腋路臂丛神经阻滞,对照组应用罗哌卡因麻醉,研究组应用艾司氯胺酮复合罗哌卡因麻醉,比较两组不同时刻[入室时(T0)、阻滞15 min(T1)、阻滞30 min(T2)、术毕(T3)]血流动力学指标[平均动脉压(MAP)、心率]水平,臂丛神经阻滞效果,感觉与运动阻滞起效时间和持续时间,手术前后疼痛程度[视觉模拟量表(VAS)]评分,以及术后24 h不良反应发生率。结果:T0~T3时,两组MAP、心率水平比较,差异均无统计学意义(P>0.05);两组臂丛神经阻滞效果比较,差异无统计学意义(P>0.05);两组感觉与运动阻滞起效时间比较,差异均无统计学意义(P>0.05);研究组感觉与运动阻滞持续时间均长于对照组,差异有统计学意义(P<0.05);术后12、24 h,研究组VAS评分均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:艾司氯胺酮复合罗哌卡因应用于腋路臂丛神经阻滞可延长感觉与运动阻滞持续时间,降低VAS评分,效果优于单纯罗哌卡因麻醉。Objective:To observe application effects of Esketamine combined with Ropivacaine in axillary brachial plexus block anesthesia.Methods:The clinical data of 76 patients with hand injuries who underwent axillary brachial plexus block anesthesia in this hospital from March 2022 to March 2023 were retrospectively analyzed.According to different anesthesia schemes,they were divided into control group and study group,38 cases in each group.The control group was anesthetized with Ropivacaine,while the study group was anesthetized with Esketamine combined with Ropivacaine.The hemodynamic indexes[mean arterial pressure(MAP),heart rate]levels at different time points[entering the room(T0),block for 15 min(T1),block for 30 min(T2),and end of the surgery(T3)],the brachial plexus block effect,the onset time and duration of sensory and motor block,the pain degree[visual analogue scale(VAS)]score before and after the surgery,and the incidence of adverse reactions 24 h after the surgery were compared between the two groups.Results:At T0~T3,there were no significant differences in the MAP and heart rate levels between the two groups(P>0.05).There was no significant difference in the brachial plexus block effect between the two groups(P>0.05).There was no significant difference in the onset time of sensory and motor block between the two groups(P>0.05).The duration of sensory and motor block in the study group was longer than that in the control group,the difference was statistically significant(P<0.05).12 and 24 h after the surgery,the VAS scores of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Esketamine combined with Ropivacaine in axillary brachial plexus block anesthesia can prolong the duration of sensory and motor block and reduce the VAS scores.Moreover,it is superior to simple Ropivacaine anesthesia.

关 键 词：艾司氯胺酮 罗哌卡因 腋路臂丛神经阻滞 手外伤 血流动力学指标 疼痛 不良反应 

分 类 号：R614[医药卫生—麻醉学]