等剂量不同浓度局麻药用于锁骨下臂丛神经阻滞效果的比较

摘要

Objective To compare the efficacy of infraclavicular brachial plexus block with same dosage and different concentrations anesthetics. Methods Ninety patients with ulnoradial fracture were randomized into three groups with 30 cases each. Levobupivacaine 50 mg and lidocaine 100 mg were diluted into three different volumes: 20 ml (group A), 30 ml (group B), and 40 ml (group C). Each group received an infraclavicular vertical brachial plexus block, and then recorded the sensory and motor block onset time, length of sensory and motor nerve blockade, anesthesia effect and adverse reactions. Results No difference was found in onset time and adverse events of the radial nerve and median nerver block. However, the ulnar nerve block onset time lasted longer in group A than in the other groups (P＜0. 05). The cases of sensory and motor nerve blockade were fewer in group A (P＜0.05). Postoperative motor blockade and sensory analgesia lasted significantly longer in group B than in the other groups. Conclusion Low concentration anesthetics could advance anesthesia effect and reduce adverse reactions while high concentration anesthetics could last longer motor blockade and sensory analgesia of infraclavicular brachial plexus block with same dosage.%目的 比较等剂量不同浓度局麻药用于锁骨下臂丛神经阻滞的效果.方法 90例尺桡骨骨折的患者,随机均分为三组.分别将左旋布比卡因50 mg复合利多卡因100 mg用生理盐水稀释至20 ml(A组)、30 ml(B组)、40 ml(C组),行垂直法锁骨下臂丛神经阻滞.观察感觉与运动神经阻滞的起效时间、维持时间、麻醉效果及其不良反应.结果 三组患者桡神经、正中神经阻滞起效时间及不良反应差异无统计学意义;A组患者尺神经阻滞起效时间长于B、C组(P＜0.05),感觉、运动神经完全阻滞例数明显少于B、C组(P＜0.01);A、C组运动恢复时间、切口疼痛时间明显短于B组(P＜0.05).结论 相同药物等剂量情况下低浓度的麻醉药可以减少不良反应和增加麻醉阻滞效果,超过一定的容量后,高浓度会延长神经阻滞的时间.