芬太尼应用于臂丛神经阻滞的镇痛效果

目的观察芬太尼用于臂丛神经阻滞的镇痛效果。方法将50例美国麻醉医师协会Ⅰ～Ⅱ级上肢手术需要臂丛神经阻滞的患者，按随机数字表随机分为试验组和对照组，各25例。试验组采用0.25%罗哌卡因＋1%利多卡因25 ml＋芬太尼0.1 mg对照组采用0.25%罗哌卡因＋1%利多卡因25 ml进行臂丛神经阻滞麻醉。比较2组手术开始切皮时及术后2、6、12 h视觉模拟疼痛评分、麻醉起效时间、持续时间。结果试验组感觉神经阻滞起效时间明显短于对照组[（3.20±0.25）min比（4.50±0.97）min]，镇痛持续时间明显长于对照组[（9.2±1.6）min比（5.1±1.2）min] ，术后2、6、12 h 视觉模拟疼痛评分低于对照组[（4.12±1.24）分比（5.63±1.23）分，（5.27±2.14）分比（7.34±1.42）分，（6.34±2.23）分比（8.35±2.15）分] （均P＜0.05）。结论芬太尼应用于臂丛神经阻滞可缩短阻滞起效时间，延长镇痛时间。

The effect of fentanyl for analgesia on brachial plexus block

ObjectiveTo observe the effect of fentanyl for analgesia on brachial plexus block. MethodsFifty patients with American Society of Anesthesiologists （ASA） grade Ⅰ Ⅱ upper limb operation with brachial plexus nerve block anesthesia were randomly divided into experimental group and control group; each group had 25 cases. Experimental group was given 0.25% ropivacaine ＋1%lidocaine 25 ml ＋ fentanyl 0.1 mg for brachial plexus block. Control group was given 0.25% ropivacaine＋1% lidocaine 25 ml. Visual analogue scale （VAS） pain score at the operation incision at the start, 2, 6 and 12 h after operation was observed; onset time and duration of anesthesia were recorded. ResultsSensory and motor block onset time in experimental group was shorter than that in control group[（3.20±0.25）min vs （4.50±0.97）min] （P〈0.05）; duration of analgesia was significantly longer than that in control group [（9.2±1.6）min vs （5.1±1.2）min] （P〈0.05）. VAS pain score was lower at 2, 6, 12 h after operation, compared with those in control group[（4.12±1.24）scores vs （5.63±1.23）scores,（5.27±2.14）scores vs （7.34±1.42）scores,（6.34±2.23）scores vs （8.35±2.15）scores]（all P〈0.05）. ConclusionFentanyl in brachial plexus block can shorten the block onset time and prolong the duration of analgesia.