摘要
目的探索0.25%罗哌卡因用于超声引导颈中间丛阻滞的半数有效容量和95%有效容量。方法选择29例行择期颈部手术的患者,均在超声引导下进行0.25%罗哌卡因颈中间丛阻滞,若颈丛分支所属皮区痛觉均消失,则视为完全阻滞(完全阻滞组,14例),否则视为不完全阻滞(不完全阻滞组,15例)。记录阻滞效果,分析0.25%罗哌卡因用于超声引导颈中间丛阻滞的有效容量;比较完全阻滞组和不完全阻滞组患者的一般特征、罗哌卡因阻滞容量、并发症发生情况及阻滞前后深吸气膈肌移动度。结果0.25%罗哌卡因用于超声引导颈中间丛阻滞的半数有效容量为10.3 ml[95%可信区间(CI)=(7.7,13.5)ml],95%有效容量为15.6 ml[95%CI=(12.8,44.0)ml]。完全阻滞组和不完全阻滞组年龄、性别、美国麻醉医师协会(ASA)分级、身高、体重及体质量指数(BMI)比较差异无统计学意义(P>0.05)。完全阻滞组用罗哌卡因容量(11.1±2.0)ml显著高于不完全阻滞组的(9.2±2.0)ml,差异有统计学意义(P<0.05)。不完全阻滞组与完全阻滞组阻滞前深吸气膈肌移动度分别为(4.17±0.87)、(4.09±0.85)cm,比较差异无统计学意义(P>0.05);不完全阻滞组与完全阻滞组阻滞后深吸气膈肌移动度分别为(4.09±0.85)、(3.99±0.70)cm,比较差异无统计学意义(P>0.05)。完全阻滞组1例患者发生声音嘶哑,其给药容量为14 ml;其余所有患者均未发生膈神经阻滞、迷走神经阻滞、局部麻醉药物中毒、Horner征或低氧血症等情况。结论0.25%罗哌卡因用于超声引导颈中间丛阻滞的半数有效容量为10.3 ml[95%CI=(7.7,13.5)ml],95%有效容量为15.6 ml[95%CI=(12.8,44.0)ml]。
Objective To investigate the effective volumes(EV)of 0.25%ropivacaine in ultrasound-guided intermediate cervical plexus block,specifically the 50%effective volume and the 95%effective volume.Methods 29 patients who underwent elective neck surgery and were selected,and 0.25%ropivacaine was used for ultrasound-guided intermediate cervical plexus block;if all the nociceptive sensations in the dermatomes belonging to the branches of the cervical plexus disappeared,it was regarded as a complete block(complete block group,14 cases);otherwise,it was regarded as an incomplete block(incomplete block group,15 cases).The block effect was recorded,and the effective volume of 0.25%ropivacaine used for ultrasound-guided intermediate cervical plexus block was analyzed;the general characteristics,volume of ropivacaine,occurrence of complications,and diaphragm excursion during deep breathing before and after block were compared between the complete block group and the incomplete block group.Results The 50%effective volume for ultrasound-guided intermediate cervical plexus block with 0.25%ropivacaine was found to be 10.3 ml[95%confidence interval(CI)=(7.7,13.5)ml],while the 95%effective volume was determined to be 15.6 ml[95%CI=(12.8,44.0)ml].There were no significant differences in age,gender,American Society of Anesthesiologists(ASA)grade,height,weight and body mass index(BMI)between the complete block group and the incomplete block group(P>0.05).The volume of ropivacaine in the complete block group was(11.1±2.0)ml,which was significantly higher than(9.2±2.0)ml in the incomplete block group,and the difference was statistically significant(P<0.05).Before block,the diaphragm excursion during deep breathing in incomplete block group and complete block group were(4.17±0.87)and(4.09±0.85)cm,and the difference was not statistically significant in comparison(P>0.05).After block,the diaphragm excursion during deep breathing in incomplete block group and complete block group were(4.09±0.85)and(3.99±0.70)cm,and the difference was no
作者
陈晓影
蒋俊丹
龚灿生
郑晓春
CHEN Xiao-ying;JIANG Jun-dan;GONG Can-sheng(Department of Anesthesiology,Fujian Provincial Hospital,Provincial Clinical College of Fujian Medical University,Fuzhou 350012,China)
出处
《中国现代药物应用》
2024年第8期111-114,共4页
Chinese Journal of Modern Drug Application
基金
福建省自然科学基金项目(项目编号:2022J011009)。
关键词
颈中间丛阻滞
罗哌卡因
有效容量
Dixon序贯法
Intermediate cervical plexus block
Ropivacaine
Effective volume
Dixon's sequential method
