【摘要】 目的探讨不同浓度罗哌卡因经超声引导下肌间沟臂丛神经阻滞的麻醉效果。方法将2016年7月至2018年6月接受上肢手术并经超声引导下罗哌卡因肌间沟臂丛麻醉的患者151例,根据年龄、体重、病情程度等随机分为A组(n=50)、B组(n=50)和C组(n=51),A、B、C3组分别接受0.3%、0.35%、0.45%罗哌卡因25 ml,观察3组的麻醉效果及/不良反应发生情况。结果 3组患者对麻醉起效时间随浓度的增加而缩短,镇痛维持时间随浓度的增加而延长,相应的麻醉后恢复时间也延长,3组比较差异均有统计学意义(P<0.05);3组麻醉有效率比较差异无统计学意义(P>0.05);3组患者麻醉后均有出现呼吸抑制、低血压、寒战、过敏性皮炎等不良反应,且随浓度升高发生率越高,但3组比较差异无统计学意义(P>0.05)。结论在选择罗哌卡因浓度时,在充分评估患者身体状况下,选择更高浓度的罗哌卡因有助于提高麻醉效果,增加患者顺应性。更多还原

【Abstract】 Objective To investigate the anesthetic effects of ropivacaine at different concentrations for ultrasound-guided intermuscular groove brachial plexus block.Methods A total of 151 patients who underwent upper limb surgery and anesthesia with ropivacaine via ultrasound-guided intermuscular groove brachial plexus block in our hospital from July 2016 to June 2018 were enrolled in the study, who were randomly divided into three groups according to age, weight, and disease condition.The patients in group A,B,C received 0.3%,0.35%,and 0.45% ropivacaine 25 ml, respectively, then the anesthetic effects, and the incidence of complications/adverse reactions were observed and compared among the three groups.Results The anesthesia onset time in the three groups was decreased with the increase of concentration, and the maintenance time of analgesia and recovery time were increased with the increase of the concentration, there were significant differences among the three groups(P<0.05). However there were no significant differences in the anesthetic effects among the three groups(P>0.05).Moreover the patients in the three groups had respiratory depression, hypotension, chills, allergic dermatitis and the other adverse reactions, and the higher the ropivacaine concentration, the higher the incidence rate of adverse reactions, but there was no significant difference among the three groups(P>0.05).Conclusion The higher ropivacaine concentration is helpful to improve the anesthetic effects and increase patient’s compliance under full assessment of patient’s body condition.更多还原