罗哌卡因在超声引导下腕部神经阻滞最低有效浓度的探讨  

Exploration of the Lowest Effective Concentration of Ropivacainein Ultrasound-Guided Wrist Nerve Block

作　　者：习琴锋 刘聪 Xi Qinfeng(Xinyu Yinhe Hospital,Jiangxi 338000)

机构地区：[1]新余银河医院,江西338000

出　　处：《黑龙江医药》2025年第1期54-58,共5页Heilongjiang Medicine journal

基　　金：新余市科技计划项目(项目编号:20233090973);项目名称:罗哌卡因在超声引导下腕部神经阻滞最低有效浓度的探讨。

摘　　要：目的:探讨罗哌卡因在超声引导下腕部神经阻滞最低有效浓度,为临床应用提供参考。方法:选择2023年2月—2024年2月腕横纹以远手外伤患者120例为对象,均在超声引导下腕部神经阻滞,根据罗哌卡因浓度不同分为四组各30例。A组采用0.375%罗哌卡因阻滞,B组采用0.3%罗哌卡因阻滞,C组采用0.25%罗哌卡因阻滞,D组采用0.2%罗哌卡因阻滞,比较四组阻滞起效、持续时间、血流动力学及安全性。结果:四组运动神经和感觉神经阻滞起效时间和阻滞持续时间具有统计学差异(P<0.05);运动神经和感觉神经阻滞起效时间排列顺序为D组>C组>B组>A组(P<0.05);阻滞持续时间排列顺序为D组<C组<B组<A组(P<0.05);四组T1时间点HR水平排列顺序为D组>C组>B组>A组(P<0.05);四组T1和T2时间点MAP排列顺序为D组<C组<B组<A组(P<0.05);四组神经阻滞药物安全性比较无统计学差异(P>0.05)。结论:0.2%罗哌卡因在超声引导下用于腕横纹以远手外伤患者腕部神经阻滞中能获得良好的效果,能稳定患者血流动力学,且未对起效和持续时间产生影响,麻醉安全性较高,值得推广应用。Objective:To investigate the minimum effective concentration of ropivacaine in wrist nerve block under ultrasound guidance,and to provide reference for clinical application.Methods:From February 2023 to February 2024,120 patients with wrist transverse trauma were selected as subjects,all of whom were wrist nerve block under ultrasound guidance,and were divided into four groups with 30 cases in each group according to different concentrations of ropivacaine.Group A received 0.375%ropivacaine block,group B received 0.3%Ropivacaine block,group C received 0.25%ropivacaine block,and group D received 0.2%ropivacaine block.The effect,duration,hemodynamics and safety of the four groups were compared.Results:The onset time and duration of motor nerve and sensory nerve block were significantly different among the four groups(P<0.05).The order of onset time of motor nerve and sensory nerve block was group D>Group C>Group B>group A(P<0.05).The order of retardation duration was group D<group C<group B<group A(P<0.05).The horizontal HR sequence at T1 time point of the four groups was group D>Group C>Group B>group A(P<0.05).The MAP arrangement of T1 and T2 time points in the four groups was group D<Group C<group B<group A(P<0.05).There was no significant difference in the safety of nerve blocking drugs among the four groups(P>0.05).Conclusion:The use of 0.2%ropivacaine in the wrist nerve block of patients with wrist stripes and distal hand trauma under ultrasound guidance can obtain a good effect,can stabilize the hemodynamics of patients,and does not affect the onset and duration of anesthesia,which is safe and worthy of popularization.

关 键 词：罗哌卡因 超声引导 腕部神经阻滞 有效浓度 疼痛程度 血流动力学 安全性 

分 类 号：R614[医药卫生—麻醉学] R681.7[医药卫生—外科学]