罗哌卡因复合地佐辛在腋路B超引导臂丛神经阻滞麻醉中的应用

崔崇英; 王龙; 王威; 刘燕; 王寒; 黄亚妮; 梁启恒

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罗哌卡因复合地佐辛在腋路B超引导臂丛神经阻滞麻醉中的应用

临床研究 | 更新时间：2023-05-22

- 罗哌卡因复合地佐辛在腋路B超引导臂丛神经阻滞麻醉中的应用
- Application of ropivacaine combined with dezocine in axillary B-ultrasound-guided brachial plexus block anesthesia
- 局解手术学杂志 2019年第4期页码：275
- 作者机构：
  
  1. 武汉大学人民医院麻醉科,湖北,武汉,430060
  2. 钟祥市人民医院麻醉科,湖北,荆门,431900
  3. 钟祥市人民医院肿瘤内科,湖北,荆门,431900
- 作者简介：
- 基金信息：
  
  2017年荆门市引导性科研计划项目（YDKY2017057）;2017～2018 年度湖北省卫生计生委适宜技术推广项目（WJ2017S017）
- DOI：
  中图分类号：
- 纸质出版日期：2019，
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崔崇英, 王龙, 王威, 等. 罗哌卡因复合地佐辛在腋路B超引导臂丛神经阻滞麻醉中的应用[J]. 局解手术学杂志, 2019,(4):275.

CUI Chong-ying, WANG long, WANG Wei, et al. Application of ropivacaine combined with dezocine in axillary B-ultrasound-guided brachial plexus block anesthesia[J]. null, 2019,(4):275.
崔崇英, 王龙, 王威, 等. 罗哌卡因复合地佐辛在腋路B超引导臂丛神经阻滞麻醉中的应用[J]. 局解手术学杂志, 2019,(4):275. DOI：

CUI Chong-ying, WANG long, WANG Wei, et al. Application of ropivacaine combined with dezocine in axillary B-ultrasound-guided brachial plexus block anesthesia[J]. null, 2019,(4):275. DOI：

摘要

目的探讨不同浓度罗哌卡因复合地佐辛在腋路B超引导臂丛神经阻滞麻醉中的效果及对心肌的影响。方法 采用前瞻性研究，随机抽取2016年1月至2018年2月湖北省钟祥市人民医院行前臂或手部手术的患者共210例，均采用罗哌卡因复合地佐辛腋路臂丛神经阻滞麻醉，按随机数字表法分为3组，每组70例。A组罗哌卡因浓度为0.33%，B组为0.40%，C组为0.50%。对比3组患者麻醉起效时间、镇痛维持时间、运动功能恢复时间、麻醉效果；通过血清肌钙蛋白（CTnI）、肌酸激酶同工酶（CKMB）观察不同浓度罗哌卡因复合地佐辛对患者心肌的影响；记录不良反应发生率。结果 A组麻醉起效时间最长，之后依次为B组和C组，A组镇痛维持时间最短，之后依次为B组和C组，A组运动功能恢复时间最短，之后依次为B组和C组，3组上述指标比较差异均有统计学意义（P＜0.05）。C组麻醉效果优率（100.00%）较B组（88.57%）和A组（82.86%）高，C组良率（0）较B组（11.43%）和A组（27.14%）低，差异均具有统计学意义（P＜0.05）。给药后24 h时3组血清CKMB、cTnI均显著升高，其中A组最低，之后依次为B组和C组。3组患者均无明显不良反应发生。结论浓度为0.40%的罗哌卡因复合地佐辛用于前臂或手部手术患者腋路臂丛神经阻滞麻醉既能满足手术需求，具备良好麻醉效果，又能减少对心肌的影响。

Abstract

Objective To analyze the effect of different concentrations of ropivacaine combined with dezocine in axillary B-ultrasound-guided brachial plexus block anesthesia and its effect on myocardium. Methods Conducted a prospective study and randomly selected 210 patients of Zhongxiang people′s hospital from January 2016 to February 2018.All of the patients were treated with ropivacaine combined with dezocine in axillary Bultrasoundguided brachial plexus block anesthesia.These patients were divided into 3 groups with 70 cases in each group by random number table.The concentration of ropivacaine was 0.33% in group A

0.40% in group B

and 0.50% in group C.The onset time of anesthesia

analgesia maintenance time

motor function recovery time and anesthesia effect were compared among the three groups.Serum troponin (CTnI) and creatine kinase isoenzyme (CKMB) were used to observe the effects of different concentrations of ropivacaine combined with dezocine on myocardium of patients.Record the incidence of adverse reactions. Results The onset time of anesthesia in group A was the longest

followed by group B and group C.The duration of analgesia in group A was the shortest

followed by group B and group C.The recovery time of motor function in group A was the shortest

followed by group B and group C.There were significant differences in the above indexes among the three groups (P<0.05).The anesthetic effect rate in group C(100.00%) was higher than those in group B(88.57%) and group A(82.86%).The yield rate in group C(0) was lower than those in group B(11.43%) and group A(27.14%)

with significant differences(P＜0.05).At 24 hours after administration

the serum CKMB and cTnI were significantly increased in the three groups

with group A being the lowest

followed by group B and group C(P<0.05).There was no obvious adverse reaction in the three groups. Conclusion Ropivacaine combined with dezocine can be uesd in axillary B-ultrasound-guided brachial plexus block anesthesia.When the concentration of ropivacaine is 0.40%

it can not only meet the needs of surgery

but also have good anesthesia effect as well as reduce the impact on myocardium.

关键词

罗哌卡因地佐辛腋路臂丛神经阻滞麻醉前臂手部浓度分析

Keywords

ropivacainedezocineaxillary brachial plexus block anesthesiaforearmhandconcentration analysis

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