摘要
目的 探讨超声引导下不同剂量罗哌卡因行肌间沟臂丛神经阻滞应用于右侧前臂手术患者的效果。方法 选取广东省韶关市乳源瑶族自治县人民医院2017年8月-2020年8月收治的100例右侧前臂手术患者,分为两组,其中A组50例采取0.33%罗哌卡因20mL麻醉,B组50例采取0.33%罗哌卡因30mL麻醉,患者手术前6h开始禁食禁水,建立静脉通路、面罩吸氧,对手术期间各项生命体征指标进行密切监测。选取2mg咪达唑仑(江苏恩华药业股份有限公司;国药准字H19990027,1mL:5mg)静脉注射进行镇静,协助患者保持平躺,使用神经阻滞的神经穿刺针(河南驼人医疗器械集团有限公司;国械准注20153152153,型号AN-N,规格:0.7×80mm)沿着臂丛后外侧部位与臂丛神经贴近,在回抽的时候无血,给予50%的麻醉药物注入其中,之后需要退针在皮下,根据进针角度进行调整,把剩下的麻醉药物注入神经周围。观察两组患者临床效果、镇痛效果和镇痛药追加次数、不良反应的发生情况。结果 B组麻醉优良率为92.00%明显高于A组64.00%(P<0.05);B组患者镇痛效果较好、镇痛药追加次数比A组少(P<0.05);B组不良反应的发生为6.00%低于A组22.00%(P<0.05)。结论 对于右侧前臂手术患者运用超声引导下剂量为0.33%罗哌卡因30mL行肌间沟臂丛神经阻滞,镇痛效果较好药物追加次数少、不良反应的发生较少,值得进一步研究。
Objective To investigate the effect of ultrasound-guided interscalene brachial plexus block with different doses of ropivacaine in patients undergoing right forearm surgery.Methods 100 patients with right forearm surgery in People’s Hospital of Ruyuan Yao Autonomous County from August 2017 to August 2020 were selected and divided into two groups,50 cases in group A were given 0.33% ropivacaine 20mL anesthesia,and 50 cases in group B were given 0.33% ropivacaine 30mL anesthesia.Fasting and water deprivation were started 6 hours before operation,venous access and oxygen inhalation were established,and vital signs were closely monitored during operation.Methods 2mg midazolam (Jiangsu Enhua Pharmaceutical Co.,Ltd;Chinese medicine Zhunzi H19990027,1mL:5mg) was injected intravenously for sedation to help the patient lie flat,and the nerve puncture needle for nerve block was used (Henan Tuoren Medical Instrument Group Co.,Ltd;state machinery approval note 20153152153,model An-N,specification 0.7 × 80 mm) along the posterolateral part of the brachial plexus,close to the brachial plexus.When there is no blood,50% of the anesthetic is injected into it.After that,the needle needs to be withdrawn in the subcutaneous,and the remaining anesthetic is injected into the peripheral nerve according to the angle of injection.The clinical effect,analgesic effect,the number of additional analgesics and the occurrence of adverse reactions were observed.Results The excellent and good rate of anesthesia in group B was 92.00%,which was significantly higher than 64.00% in group A (P<0.05).The analgesic effect of group B was better than that of group A (P<0.05).The incidence of adverse reactions in group B was 6.00%,which was lower than 22.00% in group A (P<0.05).Conclusion For patients with right forearm surgery,ultrasound-guided intramuscular sulcus brachial plexus block with 0.33% ropivacaine 30mL has better analgesic effect,less drug addition and less adverse reactions,which is worthy of further study.
作者
聂郁斐
陈志斌
NIE Yu-fei;CHEN Zhi-bin(Department of Anesthesiology,People's Hospital of Ruyuan Yao Autonomous County,Shaoguan,Guangdong 512700)
出处
《智慧健康》
2021年第28期138-140,共3页
Smart Healthcare
关键词
超声引导
罗哌卡因
肌间沟臂丛神经阻滞
右侧前臂手术
Ultrasound guidance
Ropivacaine
Interscalene brachial plexus block
Right forearm surgery
