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超声引导下应用不同浓度罗哌卡因对老年上肢手术患者行臂丛神经阻滞效果对比

Effects comparison of different concentrations of ropivacaine for brachial plexus block in elderly patients with upper limb surgery under ultrasound guidance

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【作者】 肖俊伟翟宇佳王洁

【Author】 XIAO Junwei;ZHAI Yujia;WANG Jie;Department of Anesthesiology, Shenzhen Luohu District People’s Hospital;

【机构】 深圳市罗湖区人民医院麻醉科

【摘要】 目的探究超声引导下应用不同浓度罗哌卡因对老年上肢手术患者行臂丛神经阻滞效果差异。方法选取2017年3月~2019年6月我院骨科收治的行上肢手术治疗的老年患者117例,根据随机数字表法分为低浓度组(0.25%)、中浓度组(0.375%)和高浓度组(0.5%)各39例。观察三组臂丛神经完全阻滞率、麻醉效果和并发症发生情况。结果高浓度组尺神经、桡神经、正中神经和肌皮神经的完全阻滞率显著高于低浓度组和中浓度组,中浓度组的完全阻滞率又显著高于低浓度组,组间比较差异有统计学意义(P <0.05);高浓度组的麻醉起效时间显著短于中浓度组和低浓度组,而镇痛持续时间、术后苏醒时间和运动阻滞恢复时间均显著长于中浓度组和低浓度组,两两比较差异有统计学意义(P <0.05);三组患者的并发症发生率差异无统计学意义(P> 0.05)。结论罗哌卡因应用于老年患者臂丛神经阻滞具有较好的安全性,随着浓度的升高,麻醉起效时间缩短,镇痛维持时间、术后苏醒时间及运动阻滞恢复时间延长,应根据患者具体情况选择合适的用药浓度。

【Abstract】 Objective To investigate the differences in effect of different concentrations of ropivacaine for brachial plexus block in elderly patients with upper limb surgery under ultrasound guidance. Methods 117 elderly patients who underwent upper limb surgery in Department of Orthopedics of our hospital from March 2017 to June 2019 were continuously included.The patients were divided into low concentration group(0.25%),middle concentration group(0.375%) and high concentration group(0.5%) according to the random number table method,with 39 patients in each group.The complete block rate of brachial plexus nerves,anesthesia effect and complications were observed in the three groups. Results The complete block rate of the ulnar,radial,median,and musculocutaneous nerves in high concentration group was significantly higher than that in low concentration group and middle concentration group.The complete block rate of middle concentration group was significantly higher than that of low concentration group.The differences were statistically significant(P < 0.05).The anesthesia onset time of high concentration group was significantly shorter than that of middle concentration group and low concentration group,while the duration of analgesia,postoperative wake-up time and motion block recovery time were significantly longer than those of middle concentration group and low concentration group.There were significant differences between the middle concentration group and the low concentration group.The difference between pairwise comparisons was statistically significant(P < 0.05).There was no significant difference in the incidence of complications among the three groups(P > 0.05). Conclusion Ropivacaine has good safety in the treatment of brachial plexus block in elderly patients.With the increase of concentration,the anesthesia onset time is shortened,the analgesic maintenance time,postoperative wake-up time and motion block recovery time are prolonged.The appropriate drug concentration should be selected according to the patient’s specific conditions.

  • 【文献出处】 中国医药科学 ,China Medicine and Pharmacy , 编辑部邮箱 ,2020年07期
  • 【分类号】R614
  • 【被引频次】4
  • 【下载频次】16
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