罗哌卡因配伍舒芬太尼对臂丛神经阻滞的效果观察

摘要

目的：观察在臂丛神经阻滞时罗哌卡因复合舒芬太尼对神经阻滞效果的影响.方法：选择择期上肢前臂手术患者30例,随机分成两组,每组15例,S 组：0.375%罗哌卡因+舒芬太尼10μg 共20 ml,R 组：0.375%罗哌卡因共20 ml,记录麻醉前、麻醉后5 min、15 min、30 min 的MAP、HR、呼吸频率,并记录神经阻滞起效时间、注药后30 min 感觉神经阻滞效果(VSA 评分)、运动神经阻滞时间和镇痛时间、运动神经阻滞完善程度、感觉神经阻滞完善程度(VSA 评分)及不良反应.结果：两组间桡神经、尺神经阻滞起效时间和注药后30 min 感觉神经阻滞效果及镇痛时间,感觉神经阻滞完善程度(VAS 评分)相比差异有统计学意义(P<0.05)；运动神经阻滞完善程度比较差异无统计学意义(P>0.05),两组均未见不良反应发生.结论：0.375%罗哌卡因加入舒芬太尼10μg 能改善臂丛神经阻滞效果,延长术后镇痛时间.%　　Objective :To observe some the clinical features of armpit brachial plexus block anaesthesia with ropivacaine combined with sufentanil. Methods :Thirty forearm surgery patients were randomly assigned to two groups.In S-group anesthetic was performed using 0.375% ropivacaine 20 ml combined with 10 μg sufentanil. In R-group anesthetic was performed only using 0.375% ropicaine 20 ml.BP,MAP,HR were recorded before and during anesthesia. Anesthesia work time,VSA of 30 min after brachial plexus block,movement block and nerve block duration,block degree and adverse reactions were recorded. Results :Compared to anesthesia work time of radial and ulnar nerve block ,VSA of 30 min after brachial plexus block and radial nerve block in S-group was significantly hiher than that R-group(P<0.05) ;VSA of sensory nerve between groups was statistically significant(P<0.05),motor nerve between groups was no statistically significant(P>0.05).Adverse reactions in S-and R-group did not finded.Conclusion :Ropivacaine combined with 10 μg sufentanil for the armpit brachial plexus block can improve the anaesthetic effect of nerve block,meanwhile the time of postoperative analgesia were extended.