不同浓度利多卡因用于臂丛神经阻滞麻醉的临床观察

目的 寻找适用臂丛神经分离阻滞麻醉的最佳利多卡因浓度。方法 选择80例前臂与手部手术患者，随机分为8组(每组各10例)，1组用0．25％罗哌卡因24ml，其他各组分别予以2％利多卡因1、2、3、4、5、6、12ml与0．25％罗哌卡因混合，混合液均为24ml，1～8组均经锁骨上入路行臂丛神经阻滞麻醉。分别记录其麻醉起效时间，5、10、15、20min时患肢肌力及感觉阻滞维持时间。结果 0．17％利多卡因能明显加快0．25％罗哌卡因的起效时间，但并不加深对运动神经的阻滞。不同浓度利多卡因与0．25％罗哌卡因的混合液与单纯0．25％罗哌卡因相比其感觉阻滞维持时间无显著差异。随利多卡因浓度增加，其运动神经阻滞作用逐渐增强。结论 0．25％的罗哌卡因与0．17％利多卡因的混合液用于锁骨上臂丛神经分离阻滞麻醉是较优的组合。

Clinical observation of brachial plexus block with different concentrations of lidocaine

Objective To observe the properties of different concentrations of lidocaine which mixed with 0.25% ropivacaine to find a best concentration of lidocaine suitable for dissociative block of supra clavicular brachial plexus.Methods Eighty adult male patients undergoing forearm or hand surgery were randomly allocated into 8 groups (for each 10 patients): one group receiving 0.25% ropivacaine 24 ml and the remaining 7 groups receiving 0.25% ropivacaine 24 ml in combination with 1 ml, 2 ml, 3 ml, 4 ml, 5 ml, 6 ml and 12 ml 2% lidocaine separately in supra clavicular brachial plexus block. The onset time, the degree of motor blockade in 5 min, 10 min, 15 min and that in 20 min after infusion, and the duration of sensation blockade were recorded.Results There was no difference among groups in duration of sensation blockade. The mixture of 0.25% ropivacaine with 0.17% lidocaine showed a rapid onset time, the less degree of motor blockade.Conclusion It's a superior combination of 0.17% lidocaine with 0.25% ropivacaine in dissociative block of brachial plexus.