布托啡诺延长罗哌卡因臂丛神经阻滞作用时间的临床观察

目的观察布托啡诺对罗哌卡因臂丛神经阻滞效果的影响。方法选择在臂丛神经阻滞下行前臂及手部手术的患者36例，ASAⅠ～Ⅱ级，随机分为二组（n=18），所用药物分别为0．5％罗哌卡因＋生理盐水1ml（A组）；0．5％罗哌卡因＋布托啡诺100μg／1ml（B组）。臂丛神经阻滞选择锁骨下入路，在神经刺激器引导下进行穿刺。观察并比较两组患者感觉阻滞起效时间和持续时间、运动阻滞起效时间和持续时间、镇痛时间以及桡神经、尺神经、正中神经和肌皮神经的阻滞成功率。结果二组间感觉和运动阻滞起效时间均无明显差异（P〉0．05），B组感觉、运动阻滞持续时间和镇痛时间均明显长于A组（P〈0．05）。二组患者间桡神经、尺神经、正中神经和肌皮神经阻滞成功率无明显差异（P〉0．05）。结论布托啡诺100μg可明显延长0．5％罗哌卡因臂丛神经阻滞时间，且没有明显的不良反应，值得临床参考。

Butorphanol prolonged the duration of ropivacaine for brachial plexus block: a clinical investigation

Objective To compare the effectiveness of butorphanol in combination with ropivacaine for brachial plexus block. Methods 36 ASA Ⅰ - Ⅱ patients (20 male,16 female) aged 18-59 years weighting 46-85 kg scheduled for upper extremity operation under plexus block were randomized into 2 groups (n = 18 each) :Group A received 0.5% ropivacaine; while group B received 0.5% ropivacaine + butorphanol 100 μg. Brachial plexus block was guided by nerve stimulator. We recorded the onset and duration of sensory block of each group,the onset and duration of motor block ,as well as the duration of analgesia. We also measured the block success rate of museulocutaneous,median,radial and ulnar nerve. Results There was no significant difference in the onset time of sensory or motor block in each group (P＞0.05). The duration of sensory or motor block in group B was significantly prolonged than in group A, the duration of analgesia in group B was significant prolonged than in group A too(P<0.05). While no significant difference was founded in the block success rate of musculocuta-neous, median,radial and ulnar nerve in each group(P＞0.05). Conclusion In combination with butorphanol 100 μg,the duration of 0.5 % ropivacaine for braehial plexus block was significantly prolonged. Maybe it provid-ed a good methord for clinical anesthesia.