罗比卡因与布比卡因用于连续臂丛阻滞术后镇痛的比较

目的:比较0.125%罗比卡因与0.125%布比卡因应用于上肢连续臂丛阻滞病人术后自控镇痛的效果。方法:45例拟行上肢择期手术病人随机分为R组、B组和N组,每组15例。术前均予肌间沟径路或腋路臂丛阻滞以及臂丛神经鞘内置管。术后R组与B组使用便携式病人自控镇痛泵,泵内液体分别为0.125%的罗比卡因和0.125%的布比卡因,N组为对照组,观察24h。记录3组患者的疼痛视觉模拟评分和镇痛药使用情况,记录R组与B组患者的运动阻滞、麻木感、局麻药用量、满意度、镇痛技术问题和并发症。结果:R组与B组在术后各个时间点的疼痛评分均较低,组间无明显差异(P>0.05)。N组疼痛评分在术后0h、3h时与R组和B组比较无明显差异(P>0.05);在术后6、12、18、24h均较高,与R组和B间差异均有显著性(P<0.05)。R组与B组镇痛满意度较高,组间无明显差异(P>0.05),运动阻滞、麻木感、补充用药、局麻药用量无统计学差异(P>0.05);技术问题与并发症两组发生率均低。结论:0.125%罗比卡因与0.125%布比卡因均可有效地用于上肢术后的连续臂丛阻滞病人自控镇痛,并且效果相似。

Comparison of continuous brachial plexus block of ropivacaine and bupivacaine for patient-controlled analgesia (PCA)

Objective To study the feasibility and efficacy of 0.125% ropivacaine versus 0.125% bupivacaine in continuous brachial plexus block for PCA following upper extremity surgery. Methods Forty-five patients scheduled for elective upper-limb surgery were randomly divided into three groups: group R, group B and group N. All patients received an interscalene or axillary brachial plexus block and perineural catheter prior to the start of operation. After the operation, patients in group R and group B received continuous postoperative analgesia with a portable infusion pump delivering analgetic solution(0.125% ropivacaine and 0.125% bupivacaine) for 24h. Group N was control group. Visual analog scale scores(VAS), analgesic and local anesthetic dosages, the sense of numbness, overall satisfaction scores, technical problems and complications were monitored and recorded. Results At all time except the 0h and 3h after operation, the VAS scores in group R and group B were lower significantly than group N. There were no significant differences between group R and group B(P >0.05). The overall satisfaction scores in group R and group B were higher than that in group N. No significant differences were found between group R and group B about motor block, the sense of numbness, supplemental analgesia and local anesthetic consumption (P >0.05). Both the technical problems and complications had low incidence. Conclusion This study demonstrated that 0.125% ropivacaine and 0.125% bupivacaine appeared similarly effective in providing patient-controlled analgesia following upper-extremity surgery.