甲磺酸罗哌卡因复合芬太尼用于颈丛阻滞麻醉的临床观察

目的观察甲磺酸罗哌卡因复合芬太尼用于颈丛阻滞的麻醉效果和不良反应情况。方法选择60例ASAI～Ⅱ级择期行一侧甲状腺次全切除术患者,随机分为观察组(A组)和对照组(B组),每组30例。两组均采用一针法在第4颈椎横突穿刺,行双侧颈浅和有肿物一侧颈深丛阻滞。A组用0.298%甲磺酸罗哌卡因加2μg/kg芬太尼,B组用0.298%甲磺酸罗哌卡因,切皮前静脉滴完2μg/kg芬太尼。观察两组麻醉效果及并发症。结果A组镇痛效果比B组好(p<0.05),A组的MAP和HR变化幅度小于B组(p<0.05),A组与B组相比不容易发生呼吸困难(p<0.05)。结论甲磺酸罗哌卡因复合芬太尼行颈丛神经阻滞,能增强麻醉效果,减少不良反应。

CLINICAL OBSERVATION OF MESYLATE ROPIVACAINE COMBINED WITH FENTANYL FOR CERVICAL PLEXUS BLOCK ANESTHESIA

Objective To observe the efficacy and adverse reactions in block anesthesia of cervical plexus by Ropivaeaine mesylate for injection combined with Fentanyl. Methods According to the grade of ASA Ⅰ-Ⅱ, 60 cases of subtotal resection of thyroid on one side were selected. The patients were divided into observe group （ group A） and contrast group （ group B） randomly, and each group had 30 cases. Both groups were made a puncture in the fourth cervical vertebra laterally by one - point method, made superficial cervical plexus block in the bilateral and the deep cervical plexus block at the side of tumor. 0. 298% ropivacaine mesylate injection combined with 2 μg/kg fentanyl was injected in the group A, whereas 0. 298% ropivacainc mesylate injection was injected in the group B and 2 μg/kg fentanyl was dripped into the vein before the skin incision. Then the efficacy and complications of anesthesia were observed＇Results The analgesic effect of group A was better than that of group B （ P 〈 0. 05）, and the MAP and HR variations of group A were less than that of group B （ P 〈 0. 05）, and group A was not easy to occur the breathing difficulties compared with group B. Conclusion The anesthetic effect was enhanced and adverse reactions were reduced by the ropivaeaine mesylate injection combined with fentanyl which made in the cervical plexus block.