罗哌卡因混合碳酸利多卡因与等效浓度罗哌卡因用于逆行锁骨下臂丛神经阻滞效果的比较

目的 比较罗哌卡因混合碳酸利多卡因与等效浓度罗哌卡因用于逆行锁骨下臂丛神经阻滞的效果.方法 择期行上肢手术患者60例,ASA分级Ⅰ或Ⅱ级,年龄18～64岁,体重49～ 98 kg,均在超声引导下行逆行锁骨下臂丛神经阻滞.采用随机数字表法,将患者随机分为2组(n＝30),A组应用0.35％罗哌卡因30ml,B组应用0.233％罗哌卡因和0.346％碳酸利多卡因混合液30 ml.于麻醉给药后每隔5 min记录臂丛神经各分支的阻滞效果(感觉阻滞效果评估采用针刺法,运动阻滞效果评估采用Bromage分级),记录感觉和运动阻滞起效时间、麻醉给药后30 min时感觉与运动阻滞有效情况和并发症的发生情况.结果 两组臂丛神经各分支的感觉和运动阻滞起效时间及阻滞有效率比较差异无统计学意义(P＞0.05).两组均未见严重并发症发生.结论 罗哌卡因混合碳酸利多卡因与等效浓度罗哌卡因行逆行锁骨下臂丛神经阻滞效果相似,提示碳酸利多卡因不能增强罗哌卡因的臂丛神经阻滞效应.

Comparison of the efficacy of ropivacaine mixed with lidocaine carbonate versus equivalent ropivacaine for retrograde infraclavicular brachial plexus block

Objective To compare the efficacy of ropivacaine-lidocaine carbonate mixture versus equivalent ropivacaine for retrograde infraclavicular brachial plexus block.Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes aged 18-64 yr weighing 49-98 kg undergoing elective upper limb surgery with ultrasoumd-guided retrograde infraclavicular brachial plexus block were randomly assigned into two groups ( n ＝ 30 each):group A 0.35％ ropivacaine 30 ml and group B 0.233％ ropivacaine mixed with 0.346％ lidocaine carbonate 30 ml.Sensory (by pinprick test) and motor block (by Bromage scale) were assessed every 5 min after block.The onset time of sensory and motor block of each brachial nerve,the effective rate of sensory and motor block at 30 min after brachial plexus block and complications were recorded.Results There was no significant difference in the onset time of sensory and motor block of each brachial nerve and the effective rate of sensory and motor nerve block between the 2 groups.No severe complication occurred in either group.Conclusions The efficacy of retrograde infraclavicular brachial plexus block with ropivacaine-lidocaine carbonate mixture and equivalent ropivacaine is similar suggesting that lidocaine carbonate does not enhance the anesthetic efficacy.