摘要
目的比较舒芬太尼、地塞米松复合罗哌卡因神经阻滞对罗哌卡因阻滞时效的影响。方法 90例患者均在神经刺激器定位下行坐骨神经复合腰丛阻滞麻醉,按随机分组、双盲给药,I组(对照组):1%罗哌卡因20mL加入生理盐水30mL,II组:1%罗哌卡因20mL加入舒芬太尼20 g(2mL)、生理盐水28mL,III组:1%罗哌卡因20mL加入地塞米松10mg(2mL)、生理盐水28mL;观察各项指标。结果 I组患者腰丛感觉阻滞持续时间和运动阻滞持续时间分别为7.9±3.6 h和5.9±3.4h,坐骨神经阻滞持续时间分别为8.2±3.5h和6.6±3.2h,明显短于II组(腰丛分别为15.1±2.4h和10.2±3.5h,坐骨神经分别为16.3±2.7h和11.7±3.8h)和III组(腰丛分别为23.6±4.2h和14.7±5.6h,坐骨神经分别为23.3±2.4h和14.1±5.1h)(P<0.01)。II组患者感觉阻滞持续时间和运动阻滞持续时间明显短于III组(P<0.01)。I组患者48h舒芬太尼的消耗量、按压总次数和有效次数明显高于II、III组(P<0.05)。结论 0.4 g.mL-1的舒芬太尼和0.2mg.mL-1地塞米松均能明显延长0.4%罗哌卡因腰丛-坐骨神经阻滞作用时间,但地塞米松较舒芬太尼延长罗哌卡因作用时间要长。
Objective To compare effects of sutentanil and dexamethasone on the action of ropivacaine. Methods 90 patients were randomly allocated into three groups with 30 cases each in a double-blinded method. Guided by a nerve stimulator, lumbar plexus combined sciatic nerve block was performed with 1%ropivacaine 20mL plus normal saline（NS） 30ml in group 1,1%ropivacaine 20mL plus sufentanil 20μg（2mL） and normal saline（NS） 28mL in group II, or 1%ropivacaine 20mL plus dexamethasone 10mg and normal saline（NS） 28mL in group III, so as to observe the each target. Results The durations of sensory and motor blockade in group I were lumbar plexus（7.9±3.6, 5.9±3.4）h and sciatic nerve（8.2＆3.5,6.6±3.2）h, respectively ,which were significantly shorter than（15.1±2.4, 10.2±3.5）h and （16.3±2.7, 11.7±3.8）h in group II and（23.6±4.2, 14.7±5.6）h and（23.3＆2.4, 14.1＆5.1）h in group III（P 〈0.01）. The durations of sensory and motor blockade in group II were significantly shorter than group III（P 〈0.01）. The post- operative sufentanil consumption and PCA button press times in group I were more than that of group II and group III（P 〈0.05） at 48h after operation. Conclusion Sufentanil 0.4 μg· mL^-1 and 0.2mg· mL^-1 dexamethasone significantly prolonged the action of ropivacaine in lumbar plexus combined sciatic nerve block and dexamethasone prolonged the action of ropivacaine more than that of sufentanil.
出处
《中国药物警戒》
2012年第12期710-712,共3页
Chinese Journal of Pharmacovigilance
作者简介
张大志，男，硕士，主治医师，临床麻醉术后镇痛
通讯作者：王怀江，男，学士，副主任医师，临床麻醉术后镇痛。E—mail：zhangdazhi23@yahoo．com．cn
