不同浓度罗哌卡因用于肌间沟臂丛神经阻滞效果的比较

目的:比较三种不同浓度罗哌卡因用于肌间沟臂丛神经阻滞的效果。方法:将择期行上肢手术患者60例随机均分为A组、B组、C组三组,分别用0.25%、0.375%和0.5%罗哌卡因各30 ml在神经刺激器引导下行肌间沟臂丛神经阻滞。观察臂丛神经各分支(腋神经、桡神经、肌皮神经、正中神经、尺神经和前臂内侧皮神经)的感觉阻滞时间,运动阻滞程度,术后持续镇痛时间,尺侧阻滞成功率。结果:三组的腋神经、桡神经和肌皮神经均阻滞完善,A组的感觉阻滞时间明显长于B组、C组(P<0.05),B组、C组比较差异无统计学意义;三组的正中神经、尺神经和前臂内侧皮神经均出现不完善阻滞,感觉阻滞时间A组>B组>C组,差异有统计学意义(P<0.05);A、B、C三组的运动阻滞程度以C组最完善,B组次之,A组最差;术后持续镇痛时间A组

Comparison of effects of different concentrations of ropivacaine on interscalene brachial plexus block

Objective This study was designed to compare effects of three different concentrations of ropivacaine on interscalene brachial plexus block. Methods Sixty patients undergone elective upper extremity surgery were randomly divided into three groups （A,B and C） on average,and they were performed the interscalene brachial plexus block by nerve stimulator with 30 ml of ropivacaine （0.25%,0.375% and 0.5%,respectively）. Duration of sensory block,effect of motor block,duration of postoperative continuous analgesia and success rate of ulnar nerve block of each branch of the brachial plexus （axillary,musculospiral,musculocutaneous,median,ulnar and medial antebrachial cutaneous nerves） were observed. Results Axillary,musculospiral and musculocutaneous nerves in the three groups were blocked perfectly,and the duration of sensory block in Group A was significantly longer than that in either Group B or C （P〈0.05） with no significant difference between Group B and C; median,ulnar and medial antebrachial cutaneous nerves in the three groups were blocked imperfectly,and the duration of sensory block in ascending order was Group A 〉 Group B 〉 Group C,with significant difference （P〈0.05）; in terms of effects of motor block in the three groups,Group C was the most perfect,followed by Group B and Group A was the worst; the duration of postoperative continuous analgesia in descending order was Group A 〈 Group B 〈 Group C,with significant difference （P〈0.05）; success rates of ulnar nerve block in the three groups were 40%,70% and 85%,respectively. Conclusion All the three different concentrations （0.25%,0.375% and 0.5%） of ropivacaine have a safe and effective impact on interscalene brachial plexus block,of which 0.5% ropivacaine blocks most perfectly.