摘要
目的:探讨小剂量艾司氯胺酮联合罗哌卡因用于臂丛神经阻滞的效果。方法:选择2019年4月—2021年4月我院经肌间沟臂丛神经阻滞下择期行上肢手术的120例患者,随机分为研究组和对照组,每组60例。对照组给予罗哌卡因,研究组给予小剂量艾司氯胺酮+罗哌卡因,比较两组麻醉效果(运动阻滞持续时间、运动阻滞见效时间、感觉阻滞持续时间、感觉阻滞见效时间)、不同时间[麻醉前(T_(0))、臂丛阻滞完毕后15 min(T_(1))、臂丛阻滞完毕后30 min(T_(2))、术毕(T_(3))]Ramsay评分、平均动脉压(MAP)、心率(HR)及血浆去甲肾上腺素(NE)、肾上腺素(E)、血清皮质醇(Cor)、血糖(BG)水平、不良反应。结果:研究组运动阻滞持续时间、感觉阻滞持续时间长于对照组,运动阻滞见效时间、感觉阻滞见效时间短于对照组,差异有统计学意义(P<0.05);研究组T_(1)-T_(4)时点Ramsay评分低于对照组,差异有统计学意义(P<0.05);研究组T_(1)-T_(3)时点MAP、HR、血浆NE、E、Cor、BG水平低于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率低于对照组,但差异无统计学意义(P>0.05)。结论:小剂量艾司氯胺酮联合罗哌卡因用于臂丛神经阻滞麻醉效果明显,不会增加不良反应,且对患者的呼吸没有抑制作用,机体指标更加正常,镇静效果更好。
Objective:To explore the effect of low-dose esketamine combined with ropivacaine for brachial plexus block.Methods:A total of 120 patients undergoing upper limb surgery under interscalene brachial plexus block in our hospital from April 2019 to April 2021 were randomly divided into study group and control group,with 60 cases in each group.The control group was given ropivacaine,and the study group was given low-dose es ketamine+ropivacaine.The anesthesia effects(duration of motor block,motor block effect time,sensory block duration,sensory block effect duration),Ramsay scores at different time points[before anesthesia(T_(0)),15 min after brachial plexus block(T_(1)),30 min after brachial plexus block(T_(2)),and operation(T_(3))],mean arterial pressure(MAP),heart rate(HR),plasma norepinephrine(NE),epinephrine(E),serum cortisol(Cor),blood glucose(BG)levels and adverse reactions were compared between the two groups.Results:The duration of motor block and sensory block in the study group were longer than those in the control group,and the effective time of motor block and sensory block were shorter than those in the control group,the difference was statistically significant(P<0.05).The Ramsay score at T_(1)-T_(4)in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).The levels of MAP,HR,plasma NE,E,Cor and BG at T_(1)-T_(3)in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion:The effect of low-dosees ketamine combined with ropivacaine in brachial plexus block anesthesia is obvious,which does not increase adverse reactions,and does not inhibit the respiration of patients.The body index is more normal,and the sedative effect is better.
作者
李珂
费凡
唐琪
张锦
LI Ke;FEI Fan;TANG Qi;ZHANG Jin(Department of Anesthesiology,Taicang First People's Hospital,Taicang 215400,Jiangsu,China;Department of Anesthesiology,Shengjing Hospital Affiliated to China Medical University,Shenyang 110004,Liaoning,China)
出处
《中国药物滥用防治杂志》
CAS
2022年第1期55-58,76,共5页
Chinese Journal of Drug Abuse Prevention and Treatment
基金
苏州科技局指导性项目(SYSD2020027)。
关键词
艾司氯胺酮
罗哌卡因
臂丛神经阻滞
麻醉效果
Esketamine
Ropivacaine
Brachial plexus block
Anaesthetization effect
