舒芬太尼对臂丛阻滞麻醉下锁骨内固定术后疼痛的影响

目的：观察舒芬太尼复合罗哌卡因行臂丛神经阻滞麻醉对锁骨内固定术术中麻醉效果和术后疼痛的影响。方法 ASAⅠ-Ⅱ级，在臂丛神经阻滞麻醉下行锁骨内固定手术患者46例，年龄18-50岁，随机分为对照组（R组）和观察组（SR组），n=23。R组选用0.3%罗哌卡因25mL，SF组为0.3%罗派卡因加舒芬太尼10μg共25mL。两组患者入室后常规监测、吸氧和开通静脉通道，高位肌间沟入路，有异感或碰到C5横突尖后分别注入配制好的药液，30min后开始手术。观察和记录两组患者麻醉前后血压、心率、脉搏血氧饱和度、麻醉效果和并发症，记录术后疼痛程度。结果两组感觉阻滞起效时间无明显差异，SR组麻醉效果好于R组，术后镇痛效果明显优于R组（P＜0.05）。两组均未出现严重并发症。结论舒芬太尼复合罗哌卡因能够加强臂丛神经阻滞效果和延长术后镇痛时间适用于锁骨内固定手术的麻醉。

Clinical Effect of Sufentanil in Brachial Plexus Block Anesthesia for Internal Fixation of Clavicular Fractures

Objective To evaluate the clinical effect of rnpivacaine combined with sufentanil in brachial plexus block anesthesia for internal fixation of clavicular fractures. Methods Sixty ASA MI patients of internal fixation of clavicular fractures under brachial plexus block anesthesia, were randomly divided into two groups： Group R（control group） were given of 0.3% ropivacaine alone, Group SR（experiment group）were given 0.3% ropivacaine plus sufentanil 10gg,（n=23）.Indexes of sensory nerve block, anesthesia parameters, the VAS score and adverse events were observed and recorded. Results The anesthesia parameters of Group SR were better than Group R, The effect of Postoperative Analgesia in Group SR was superior to Group R（P〈0.05）. No statistical differences was found on adverse events between the two group. Conclusion Combined use of sufentanil（10μg）and 0.3% ropivacaine 25mL in brachial plexus block anesthesia had perfect Postoperative Analgesia for internal fixation of clavicular fractures.