不同浓度罗哌卡因用于儿童肌间沟臂丛神经阻滞的效应比较

目的探讨不同浓度罗哌卡因用于儿童臂丛神经阻滞的有效性和安全性。方法100例择期行上肢手术的患儿随机分成四组（各组25例）：A组用0．33％罗哌卡因；B组用0．25％罗哌卡因；C组用0．2％罗哌卡因；D组用0．167％罗哌卡因。记录患儿麻醉前（Tn）及手术开始后1min（T1）、10min（T2）、120min（T3）平均动脉压、心率；记录氯胺酮的用量、镇痛维持时间、运动恢复时间及患儿不良反应情况；记录麻醉效果评级。结果D组在T1、T2、T3各个时点MAP和HR明显高于术前基础值，与其余三组比较，差异均有统计学意义（均P〈0．05）；A组、B组和C组在麻醉效果上相比，差异无统计学意义（均P〉0．05），D组麻醉效果较差，与其余三组相比差异有统计学意义（均P〈0．05）；D组氯胺酮用量与A组、B组和C组比较，差异有统计学意义（均P〈0．05）；D组的镇痛维持时间和运动恢复时间与其它三组比较有显著性差异（P〈0．05）。结论0．25％罗哌卡因镇痛效应好，不良反应少，更适用于儿童上肢手术。

A comparison of ropivacaine of different concentration for interscalene brachial plexus block on children

Objective To investigate the efficacy and safety to children of different concentration ropivacaine used for braehial plexus block in upper-limb paediatfic surgery.Methods After undergoing basal anesthesia with ketamine,100 children scheduled for hand and forearm surgery were randomly allocated to receive brachial olexus block.Brachial plexus block was performed separately with 0.33% ,0.25% ,0.2% ,0.167% ropivacaine in four group.The onset time and complete time of sensory blockade of ulner nerve,medial nerve and radial nerve;duration of analgesia;satisfaction degree of nerve block and complications were recorded.Results MAP and HR in group D was higher than before anesthesia at T1,T2,T3,and was higher compared with other three groups at T1,T2 ,T3.There wasn' t significantly difference in anesthetic effect among A,B,C group and D group was the worst,compared with other three groups.The amount of ketamine and the rate of adverse reactions in D group was significantly more than that in other three groups.The time of analgesic and movement to restore was shorter than that in other three groups.Conclusion 0.25% ropivacaine was more applicable to children with anesthetized perfectly and less complication.