摘要
目的探讨肩关节镜手术中在超声引导下行臂丛上干和颈浅丛神经阻滞时应用不同浓度罗哌卡因的效果。方法选取60例ASAⅠ~Ⅱ级行肩关节镜手术的患者,在超声引导下行臂丛上干和颈浅丛神经阻滞,随机分为两组,每组30例。A组为0.25%罗哌卡因组,B组为0.35%罗哌卡因组。记录患者术前(T_0)、手术开始5 min(T_1)、手术开始30 min(T_2)和拔除喉罩30 min后(T_3)患者的心率(HR)、平均动脉压(M AP),手术时间,拔管时间(停用七氟烷至拔除喉罩时间)及阿片类镇痛药物(舒芬太尼)、七氟烷使用量,患者在麻醉后监测治疗室(PACU)及术后3、6、9、12 h的疼痛VAS(visual analogue score)评分及肌力分级等指标。结果与A组相比较,B组术后6、9、12 h的疼痛VAS评分显著降低(P<0.05),并且B组PACU、术后3 h的肌力分级明显降低(P<0.05)。两组患者在T_0、T_1、T_2、T_3时的HR和MAP差异无统计学意义(P>0.05);两组拔管时间,舒芬太尼、七氟烷使用量,PACU、术后3 h疼痛VAS评分,术后6、9、12 h肌力分级差异无统计学意义(P>0.05)。结论肩关节镜手术中应用0.35%罗哌卡因行超声引导臂丛上干和颈浅丛神经阻滞,不仅能够达到理想的麻醉效果,还能提供更长时间的术后镇痛。
ObjectiveTo compare the different doses of ropivacaine for ultrasound guided superior trunk of brachial plexus and superficial cervical plexus block in arthroscopic shoulder surgery.MethodsSixty ASAⅠⅡpatients undergoing arthroscopic shoulder surgery with ultrasound guided superior trunk of brachial plexus and superficial cervical plexus block were divided into two groups:025%ropivacaine was administrated for block anesthesia in group A and035%ropivacaine was administrated in group B.The mean arterial blood pressure(MAP)and heart rate(HR)before the surgery(T0),5min(T1),30min(T2)after the beginning of the surgery,and30min after removing the laryngeal mask(T3)were recorded.The operation time,extubation time,dosage of sufentanyl,dosage of sevoflurane were documented.The pain visual analogue score(VAS)and muscle strength grades at post anesthesia care unit(PACU),3h,6h,9h and12h after the surgery were all analyzed.ResultsCompared with group A,patients in group B had significantly lower VAS scores at6h,9h,12h after the surgery(all P<0.05),lower muscle strength grades at3h after the surgery(P<0.05).There were no significant differences in MAP and HR at T0,T1,T2,T3,extubation time,dosage of sufentanyl,dosage of sevoflurane,VAS scores at PACU,VAS scores at3h after the surgery,muscle strength grades at6h,9h,12h after surgery between two groups.ConclusionSuperior trunk of brachial plexus and superficial cervical plexus block with035%ropivacaine can provide excellent anesthetic effect and offers longer analgesic time.
作者
孙世宇
郭建荣
赵宏程
陈明慧
常涛
胡超力
SUN Shi-yu;GUO Jian-rong;ZHAO Hong-cheng;CHEN Ming-hui;CHANG Tao;HU Chao(Dept.of Anesthesiology, First Affiliated Hospital, Wannan Medical College, Wuhu 241001, Auhui Province, China;Dept.of Anesthesiology, Tenth Peopled Hospital, Tongji University, Shanghai 200072, China;Dept.of Anesthesiology, Gongli Hospital, Second Military Medical University, Shanghai 200135, China)
出处
《同济大学学报（医学版）》
CAS
2017年第5期74-78,共5页
Journal of Tongji University(Medical Science)
基金
上海市浦东新区医学领先人才项目(PWR12013-03)
关键词
肩关节镜手术
臂丛上干神经阻滞
颈浅丛神经阻滞
罗哌卡因
arthroscopic shoulder surgery
superior trunk of brachial plexus block
superficial cervical plexus block
ropivacaine
作者简介
孙世宇(1989—),男,硕士研究生.E-mail:sunshiyu0407@126.com;通信作者:郭建荣.E-mail:guojianrongvvip@163.com
