1%甲哌卡因与0.5%罗哌卡因用于肌间沟臂丛神经阻滞锁骨骨折术中的比较

目的观察1%甲哌卡因与0.5%罗哌卡因用于肌间沟臂丛神经阻滞锁骨骨折术中麻醉效果的比较。方法择期行肌间沟臂丛神经阻滞锁骨骨折成年患者30例,ASAⅠ~Ⅱ级,随机分为2组(n=15);1%甲哌卡因组(M组)和0.5%罗哌卡因组(R组)。两组均在神经刺激仪引导下,以肌间沟入路行臂丛神经阻滞,M组和R组分别注入1%甲哌卡因25 mL和0.5%罗哌卡因25 mL。观察两组血流动力学,感觉、运动阻滞起效及恢复时间,术后VAS评分,不良反应及麻醉满意度。结果与R组比较,M组感觉、运动阻滞起效时间缩短,阻滞恢复时间缩短(P0.05),术后6 h、12 h的VAS评分增加(P0.05)。结论 1%甲哌卡因与0.5%罗哌卡因行肌间沟臂丛神经阻滞,均能满足锁骨骨折手术。采用1%甲哌卡因较0.5%罗哌卡因起效更快,且感觉、运动恢复更早,利于早期活动,但术后镇痛效果不如0.5%罗哌卡因。

The effectiveness of 1% Mepivacaine and 0.5% ropivacaine used for brachial plexus nerve block in clavicle fracture surgery

［Abstract］ Objective To compare the efficacy of 1% Mepivacaine with 0.5% ropivacaine on brachial plexus nerve block in clavicle fracture surgery. Methods Thirty adult patients（ASAI~II）undergoing clavicle fracture surgery were randomly divided into two groups（n=15），1% mepivacaine group（group M）and 0.5% ropivacaine group（group R）. Patients in two groups both acceptted brachial plexus nerve block guided by nerve stimulator，and patients in group M and group R were injected 1% mepivacaine or 0.5% ropivacaine 25 ml separately. The hemodynamic，sensory and motor block onset and recovery time， postoperative VAS score，adverse reactions and anesthesia satisfaction were observed in the two groups. Results Compared with group R，the onset time of sensory and motor block was shortened in group M， the time of block recovery was shortened（P<0.05），and the scores of 6 h and 12 h were increased（P< 0.05）after operation（VAS < 0）. Conclusion Brachial plexus nerve block with 1% mepivacaine and 0.5% ropivacaine both can satisfy clavicle fracture surgery. The use of 1% mepivacaine was faster than the 0.5% ropivacaine，and the sensory and motor recovery was earlier in group M，which was beneficial to the early stage of operation，but the analgesic effect was less than 0.5% ropivacaine.