高频超声引导锁骨上臂丛阻滞罗哌卡因和利多卡因最小有效容量的临床研究

摘要

目的：探讨高频超声引导下锁骨上臂丛神经阻滞局麻药0．375％罗哌卡因和1％的利多卡因最小有效容量。方法选择拟行前臂及手部手术的美国麻醉医生协会（ ASA ）Ⅰ～Ⅱ级手术患者若干例，每一组15例患者，第一组起点容量定为20 ml，若阻滞效果完善则在此基础上减少2 ml，容量（18 ml）作为第二组，若第二组阻滞效果完善则再次减少2 ml作为第三组（16 ml），若第二组阻滞效果不完善，第三组容量则选取第一组和第二组的中位剂量作为第三组（19 ml），如此反复设定新的剂量分组，直到相邻两组的容量差值≤1 ml为止得到最小容量。结果在本次研究中，20．00 ml、18．00 ml、16．00 ml各组的15例患者均达到阻滞完善的效果，15．00 ml和14．00 ml组各有1例和2例患者未达到阻滞完善的手术要求，在高频超声引导下经锁骨下行第二次臂丛神经阻滞达到完善水平。20．00 ml、18．00 ml、16．00 ml各组患者的感觉阻滞起效时间、感觉阻滞完善时间、运动阻滞完善时间、镇痛持续时间构成差异无统计学意义（P＞0．05）。结论高频超声引导下锁骨上臂丛神经阻滞局麻药0．375％罗哌卡因和1％的利多卡因最小有效容量为16．00 ml。%Objective To discuss the minimum effective capacity of local anesthetics with 0.375%Ropivacaine and 1% Lidocaine used in the high-frequency ultrasound-guided supraclavicular brachial plexus block.Methods Selected undergoing forearm and hand surgery American anesthesiologist Association ( ASA) gradeⅠ ~II, several cases of surgery patients , 15 patients in each group , the first group starting capacity as 20 ml, if the blocking effect was perfect in this reduction on the basis of 2 ml, capacity (18 ml) as a second group, the second group of retarding effects if perfect again 2 ml as a third group (16 ml), if the second set of blocking effect was imperfect , and then the third group capacity selected the first group and the second group median dose as a third group (19 ml), and so forth to set a new dose packets , until the capacity of the difference between two adjacent ≦1 ml, and then got the minimum capacity .Results In this study, 20.00 ml, 18.00 ml, 16.00 ml, 15 patients in each group reached complete block effect , 15.00 ml and 14.00 ml each group l patients and 2 patients did not reach complete block of surgery requirements , at high frequency ultrasound-guided supraclavicular brachial plexus , second downlink reached perfect level .20.00 ml, 18.00 ml, 16.00 ml patients in each group of sensory block onset time , sensory block perfect time , perfect time motor block , constitution of analgesia duration has no significant difference (P >0.05).Conclusions High frequency ultrasound guided infraclavicular brachial plexus block is established with local anesthetics ropivacaine 0.375% and 1% lidocaine with minimum effective volume for 16.00ml.