罗哌卡因复合咪达唑仑对臂丛阻滞效果的影响

目的评价局麻药罗哌卡因复合咪达唑仑对肌间沟臂丛阻滞效果的影响。方法需行上肢手术的成年病人40例,ASAⅠ-Ⅱ级,按单双号随机分为两组,均行肌间沟臂丛阻滞。A组20例,局麻药用0.25%罗哌卡因。B组20例用0.25%罗哌卡因加50μg/kg咪达唑仑,记录麻醉起效时间、持续时间及术后24 h止痛药的需要量。结果感觉和运动神经阻滞起效时间B组比A组明显加快,镇痛时间B组比A组显著延长（P〈0.05）;B组术后24 h对疼痛药的需要量明显减少（P〈0.05）。血流动力学及血氧饱和度术后两组无明显差别。结论0.25%罗哌卡因复合咪达唑仑臂丛阻滞使感觉和运动神经阻滞起效时间缩短,镇痛时间明显延长,术后24 h止痛药用量明显减少,改善了术后镇痛质量,但并不延长运动阻滞时间。

Effect of Midazolam Combines with Ropivacaine on Brachial Plexus Block

Objective To evaluate the effect of midazolam combines with ropivacaine on brachial plexus block of interscalene. Methods 40 adult patients of ASA Ⅰ - Ⅱ were divided into two groups according to single-double order and undergoing limb surgeries under brachial plexus block. Patients in group A （n =20） were administered 30 ml of 0.25% ropivacain and group B （n =20） were administered 30 ml of 0.25% roplvacaln with midazolam 50 μg/kg. Hemodynamic variables （e ,g, heart rate, noninvasive blood pressure）, SpO2 and rescue analgesie requirements were reeorded for 24 hours postoperatively. Results The onset of sensory and motor block in group B was faster significantly than that in group A （P 〈 0. 05 ）. The duration of the analgesia was prolonged significantly,however,the duration of motor block did not differ between groups. Rescue analgesic requirements in group B were less significantly than that in group A from one hour to 24 hours postoperatively （P 〈0. 05）, but hemodynamics and SpO2 did not differ between groups in 24 hours postoperatively. Conclusion Midasolam （50 μg/kg） in combination with 30 ml （0.25%） ropivacain hastened onset of sensory and motor block and prolonged duration of the analgesia, and postoperative analgesia improved when they used in braehial plexus block,without prolonged duration of motor block.