小剂量瑞芬太尼复合丙泊酚辅助臂丛神经阻滞的临床观察

目的 观察小剂量瑞芬太尼复合丙泊酚辅助臂丛神经阻滞的临床效果.方法 60例ASAⅠ～Ⅱ级择期行上肢手术的患者随机分为瑞芬太尼复合丙泊酚组（R组）和芬太尼氟哌利多组（F组）,每组30例.观察并记录平均动脉压（MAP）、心率（HR）、血氧饱和度（SPO2）、呼吸频率（RR）、口述镇痛评分（VPS）、术中合作度评分.术中行血气分析测定PO2和PCO2.结果 术中R组HR、MAP、RR较F组明显降低（P〈0.05）,VPS评分、术中合作度评分明显优于F组（P〈0.05）.2组患者均无明显的呼吸抑制.结论 小剂量瑞芬太尼复合丙泊酚辅助臂丛神经阻滞用于上肢手术麻醉安全有效.

Clinical effects of the low- dose of remifentanil combined with propofol aid brachial plexus block

Objective To observe the clinical effects of the low - dose of remifentanil combined with propofol aid brachial plexus block in arm surgery. Methods Sixty patients of ASA grade Ⅰ -Ⅱ undergoing selective arm surgery were randomly divided into two groups with 30 cases each, group R（ remifentanil combined with propofol） and group F （ fentanil and droperidol）. To observe and record the changes of HR, MAP, SPO2, RR, assessment of VPS and cooperation. PO2 and PCO2 were monitored by blood gas analysis during surgical procedures. Results Compared with group F, the changes of HR, MAP, RR of Group R were significantly decreased in the surgery （P 〈 0.05）. Assessment of VPS and cooperation of Group R were significantly better than group F （ P 〈 0.05 ）. Both the group have no significantly respiratory depression. Conclusion Low dose of remifentanril combined with propofol aid brachial plexus block in arm surgery was safe and effective.