[1]香效明,杨智学,林有梅,等.罗哌卡因不同注药速度对超声联合神经刺激仪引导锁骨上臂丛神经阻滞术后镇痛效果的影响[J].医学信息,2020,33(18):69-72.[doi:10.3969/j.issn.1006-1959.2020.18.021]
　XIANG Xiao-ming,YANG Zhi-xue,LIN You-mei,et al.Effects of Different Injection Speeds of Ropivacaine on the Analgesic Effect of Supraclavicular Brachial Plexus Block Guided by Ultrasound Combined with Neurostimulator[J].Medical Information,2020,33(18):69-72.[doi:10.3969/j.issn.1006-1959.2020.18.021]
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罗哌卡因不同注药速度对超声联合神经刺激仪引导锁骨上臂丛神经阻滞术后镇痛效果的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年18期
页码:
69-72
栏目:
论著
出版日期:
2020-09-15

文章信息/Info

Title:
Effects of Different Injection Speeds of Ropivacaine on the Analgesic Effect of Supraclavicular Brachial Plexus Block Guided by Ultrasound Combined with Neurostimulator
文章编号:
1006-1959（2020）18-0069-04
作者:
香效明; 杨智学; 林有梅; 等
（东莞市横沥医院麻醉科，广东 东莞 523460）
Author(s):
XIANG Xiao-ming; YANG Zhi-xue; LIN You-mei; et al
(Department of Anesthesiology,Hengli Hospital,Dongguan 523460,Guangdong,China)
关键词:
罗哌卡因; 注药速度; 超声; 神经刺激仪引导; 锁骨上臂丛神经阻滞; 术后镇痛
Keywords:
Ropivacaine; Injection speed; Ultrasound; Guidance by nerve stimulator; Supraclavicular brachial plexus block; Postoperative analgesia
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2020.18.021
文献标志码:
A
摘要:
目的 探讨0.375%罗哌卡因不同注药速度对超声联合神经刺激仪引导锁骨上臂丛神经阻滞术后镇痛效果的影响。方法 选择我院2017年5月~2020年5月择期行单侧上肢骨折内固定手术患者100例作为研究对象，随机分为低速组（L组）和高速组（H组），各50例，两组患者均采用超声联合神经刺激仪引导锁骨上臂丛神经阻滞，注射0.375%罗哌卡因30 ml，L组注药速度为20 ml/h，H组注药速度为40 ml/h。比较两组感觉阻滞起效时间、运动阻滞起效时间、感觉阻滞持续时间、运动阻滞持续时间、麻醉效果、术后2、4、6、12、24、48 h VAS评分；记录两组术后首次按压镇痛泵时间、术后48 h舒芬太尼使用量、镇痛泵按压总次数、镇痛满意度、臂丛神经阻滞并发症和镇痛相关并发症发生率。结果 H组感觉阻滞起效时间、运动阻滞起效时间短于L组（P＜0.05），且H组感觉阻滞持续时间、运动阻滞持续时间长于L组（P＜0.05）；两组麻醉效果比较，差异无统计学意义（P＞0.05）；H组术后12 h VAS评分低于L组（P＜0.05），其余时间点两组VAS评分比较，差异无统计学意义（P＞0.05）；H组术后48 h舒芬太尼使用量、镇痛泵按压总次数低于L组（P＜0.05），术后首次按压镇痛泵时间长于L组（P＜0.05）；两组患者镇痛满意度比较，差异无统计学意义（P＞0.05）；两组均未发生臂丛神经阻滞及镇痛相关并发症。结论 0.375%罗哌卡因注药速度是影响双重引导锁骨上臂丛神经阻滞术后镇痛效果的因素之一，与20 ml/min注药速度相比，40 ml/min注药速度起效时间更短，维持时间更长，术后镇痛效果更佳，持续时间更长，术后舒芬太尼用量少，且不会增加阻滞相关并发症的发生率。
Abstract:
Objective To explore the effect of different injection speeds of 0.375% ropivacaine on the analgesic effect of supraclavicular brachial plexus block guided by ultrasound combined with neurostimulator.Methods 100 patients with elective internal fixation of unilateral upper limb fractures in our hospital from May 2017 to May 2020 were selected as the research objects. They were randomly divided into low-speed group (L group) and high-speed group (H group), with 50 cases in each. Both groups of patients were guided by ultrasound combined with nerve stimulator to guide supraclavicular brachial plexus nerve block, and injected 0.375% ropivacaine 30 ml, the injection rate of group L was 20 ml/h, and the injection rate of group H was 40 ml/h. Compare the onset time of sensory block, the onset time of motor block, the duration of sensory block, the duration of motor block, the effect of anesthesia, and the VAS scores at 2, 4, 6, 12, 24, and 48 h after operation between the two groups; The time of first pressing the analgesic pump after operation, the amount of sufentanil used 48 h after the operation, the total number of analgesic pump pressings, the satisfaction degree of analgesia, the complications of brachial plexus block and the incidence of analgesia-related complications in the two groups. Results The onset time of sensory block and motor block in group H was shorter than that in group L (P＜0.05), and the duration of sensory block and motor block in group H was longer than that in group L (P＜0.05); There was no statistically significant difference in the effect of anesthesia (P>0.05); the VAS score of the H group was lower than that of the L group at 12 h after the operation (P<0.05), and there was no significant difference in the VAS score between the two groups at other time points (P>0.05); 48 h after surgery, the amount of sufentanil used and the total number of compressions of the analgesic pump in the H group were lower than those in the L group (P＜0.05), and the first compression of the analgesic pump after surgery was longer than that of the L group (P＜0.05); There was no significant difference in satisfaction with analgesia between the two groups (P>0.05); there was no brachial plexus block and analgesia-related complications in the two groups.Conclusion The injection rate of 0.375% ropivacaine was one of the factors affecting the postoperative analgesic effect of dual-guided supraclavicular brachial plexus block. Compared with the injection rate of 20 ml/min, the injection rate of 40 ml/min was effective time was shorter, the maintenance time was longer, the postoperative analgesia effect was better, the duration was longer, the postoperative sufentanil dosage was less, and the incidence of block-related complications would not increase.

参考文献/References:

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更新日期/Last Update: 1900-01-01