相同剂量不同浓度的罗哌卡因用于腰丛坐骨神经联合阻滞的临床研究

目的：观察相同剂量不同浓度的罗哌卡因用于腰丛坐骨神经联合阻滞的临床效果。方法：择期行单侧下肢手术的患者90例，年龄18～65岁，ASAⅠ或Ⅱ级，随机分为3组（n=30）：A组给予0．3％的罗哌卡因腰丛36mL、坐骨神经24mL，B组给予0．36％的罗哌卡因腰丛30mL、坐骨神经24mL，C组给予0．4％罗哌卡因腰丛27mL、坐骨神经18mL。分别于给药后2、5、10、15、20、25、30、35min测定下肢的感觉、运动评分以及感觉阻滞的时间和运动阻滞的时间。结果：三组患者阻滞起效时间无明显差别，高容量组完全阻滞的持续时间短于低容量组；高容量低浓度组患者完全阻滞率高于低容量组，但达到完全阻滞时间长于低容量组。结论：在剂量相同时罗哌卡因的浓度和容量会影响腰丛和坐骨神经的阻滞效果；高容量罗哌卡因更有利于达到良好的感觉阻滞。

The Clinical Trial of the Same dose Ropivacaine after Lumbar Plexus with Sciatic Nerve Block

Objective：To investigate the of different concentration of the same doses ropivacaine after lumbar plexus with sciatic nerve block. Methods： After obtaining written informed consent 90 ASA Ⅰ or Ⅱ patients scheduled for unilateral lower-extremity surgery using lumbar plexus with sciatic nerve block were randomly divided into three groups（n =30 each）：group A received 0.3% ropivacaine 60 mL（lumbar-plexus 36 mL,sciatic nerve 24 mL）,group B received 0.36% ropivaeaine 50 mL（lumba〉plexus 30 mL, sciatic nerve 20 mL）,group C received 0. 4% ropivacaine 45 mL （lumbar-plexus 27 mL, sciatic nerve 18 mL）. sensory and motor were evaluated at 2,5,10.15.20.25.30,35min after drug injected,and recorded the duration of the nerve blockade o Results：The onset time of nerve blockade among these groups were no difference;The blockade duration in the larger volumes was shorter than that of the smaller volumes; The rate of completely blockade in the larger volumes of dilute ropivacaine was higher. Conclusion： At the same dose ropivacaine,which concentration and volume can influence block characteristics. A relatively higher volume is benefit to reach better insensate.