小剂量纳洛酮复合罗哌卡因或舒芬太尼—罗哌卡因对臂丛阻滞的影响
发布时间：2018-08-10 07:58
【摘要】：目的:评价小剂量纳洛酮复合罗哌卡因或舒芬太尼-罗哌卡因混合液对超声引导下臂丛阻滞的影响。方法:选择我院行上肢手术的患者100例,将其随机分为四组,每组25例。0.375%甲磺酸罗哌卡因20ml(D组);0.375%甲磺酸罗哌卡因+10μg舒芬太尼共20ml(S组);0.375%甲磺酸罗哌卡因+100ng纳洛酮共20ml(N组);0.375%甲磺酸罗哌卡因+10μg舒芬太尼+100ng纳洛酮共20ml(N+S组)。所有患者均在超声引导下行肌间沟臂丛神经阻滞麻醉,观察并记录给药后5min、15min、30min、6h、12h、18h、24h手术区域感觉阻滞情况、运动阻滞情况及不良反应情况。结果:D组的感觉阻滞持续时间及运动阻滞持续时间分别为(435.5±77.9min)及(350.2±69.8min),S组为(831.7±52.0min)及(675.8±48.1min),N组为(933.0±117.1min)及(499.0±40.5min),N+S组为(919.3±59.0min)及(534.8±56.6min)。四组患者性别比例、年龄、身高、体重、BMI、ASA分级差异均无统计学意义。N组和N+S组的感觉阻滞持续时间比D组和S组长(P0.05)。D组的感觉阻滞持续时间及运动阻滞持续时间比其他组短(P0.05)。所有组的感觉阻滞起效时间和运动阻滞起效时间差异无统计学意义。给药后5 min、24 h四组患者的VAS疼痛评分差异无统计学意义。给药后6h、12 h,D组的VAS疼痛评分明显高于S组、N组和N+S组(P0.05)。给药后18 h,D组和S组的VAS疼痛评分明显高于N组和N+S组(P0.05)。四组患者均未出现头晕、恶心呕吐、嗜睡、皮肤瘙痒、局麻药毒性反应、呼吸抑制等不良反应。结论:添加小剂量纳洛酮(100ng)于0.375%的罗哌卡因中用于臂丛神经阻滞麻醉,有或没有舒芬太尼,可以延长感觉和运动阻滞的持续时间,有效降低术后疼痛,有助于患者术后早日进行功能锻炼,且未增加不良反应,安全可靠,是一种安全、有效的神经阻滞方法,值得临床推广运用。
[Abstract]:Aim: to evaluate the effect of low-dose naloxone combined with ropivacaine or sufentanil-ropivacaine on ultrasound-guided brachial plexus block. Methods: 100 patients undergoing upper limb operation in our hospital were randomly divided into four groups. 25 patients with ropivacaine mesylate 20ml (group D) 0.375% ropivacaine mesylate 10 渭 g sufentanil plus 20ml (group S) 0.375% ropivacaine mesylate 100ng naloxone with 20ml (group N) 0.375% ropivacaine mesylate 10 渭 g sufentanil 100ng naloxone (20ml (N S group). All the patients were anesthetized with intermuscular sulcus brachial plexus block under the guidance of ultrasound. The sensory block, motor block and adverse reactions were observed and recorded at 5 min, 15 min, 30 min, 6 min, 12 h, 18 h and 24 h after administration. Results the duration of sensory block and motor block were (435.5 卤77.9min) and (350.2 卤69.8min) vs (831.7 卤52.0min) and (675.8 卤48.1min) in group N and (933.0 卤117.1min), (919.3 卤59.0min) and (534.8 卤56.6min) in group N and (499.0 卤40.5min) N, respectively. There was no significant difference in sex ratio, age, height, weight and BMI-ASA grade among the four groups. The duration of sensory block and motor block in group N and group N were shorter than those in group D and group S (P0.05). The duration of motor block in group D was shorter than that in group D (P0.05). There was no significant difference in the onset time of sensory block and motor block in all groups. There was no significant difference in VAS pain score between the four groups at 5 min and 24 h after administration. The VAS pain score of group D was significantly higher than that of group S and group N (P0.05). The VAS pain scores in group D and group S were significantly higher than those in group N and group N (P0.05). There were no adverse reactions such as dizziness, nausea and vomiting, lethargy, pruritus, local anesthetic toxicity and respiratory inhibition in the four groups. Conclusion: adding low dose of naloxone (100ng) in 0.375% ropivacaine for brachial plexus block anesthesia with or without sufentanil can prolong the duration of sensory and motor block and effectively reduce postoperative pain. It is a safe and effective method of nerve block, which is worth popularizing in clinic.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R614
[Abstract]:Aim: to evaluate the effect of low-dose naloxone combined with ropivacaine or sufentanil-ropivacaine on ultrasound-guided brachial plexus block. Methods: 100 patients undergoing upper limb operation in our hospital were randomly divided into four groups. 25 patients with ropivacaine mesylate 20ml (group D) 0.375% ropivacaine mesylate 10 渭 g sufentanil plus 20ml (group S) 0.375% ropivacaine mesylate 100ng naloxone with 20ml (group N) 0.375% ropivacaine mesylate 10 渭 g sufentanil 100ng naloxone (20ml (N S group). All the patients were anesthetized with intermuscular sulcus brachial plexus block under the guidance of ultrasound. The sensory block, motor block and adverse reactions were observed and recorded at 5 min, 15 min, 30 min, 6 min, 12 h, 18 h and 24 h after administration. Results the duration of sensory block and motor block were (435.5 卤77.9min) and (350.2 卤69.8min) vs (831.7 卤52.0min) and (675.8 卤48.1min) in group N and (933.0 卤117.1min), (919.3 卤59.0min) and (534.8 卤56.6min) in group N and (499.0 卤40.5min) N, respectively. There was no significant difference in sex ratio, age, height, weight and BMI-ASA grade among the four groups. The duration of sensory block and motor block in group N and group N were shorter than those in group D and group S (P0.05). The duration of motor block in group D was shorter than that in group D (P0.05). There was no significant difference in the onset time of sensory block and motor block in all groups. There was no significant difference in VAS pain score between the four groups at 5 min and 24 h after administration. The VAS pain score of group D was significantly higher than that of group S and group N (P0.05). The VAS pain scores in group D and group S were significantly higher than those in group N and group N (P0.05). There were no adverse reactions such as dizziness, nausea and vomiting, lethargy, pruritus, local anesthetic toxicity and respiratory inhibition in the four groups. Conclusion: adding low dose of naloxone (100ng) in 0.375% ropivacaine for brachial plexus block anesthesia with or without sufentanil can prolong the duration of sensory and motor block and effectively reduce postoperative pain. It is a safe and effective method of nerve block, which is worth popularizing in clinic.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R614
【参考文献】
相关期刊论文 前10条
1 赵军;刘国强;高宝柱;郑宝森;曹君利;鲁显福;刘功俭;;鞘内注射小剂量纳洛酮、吗啡和芬太尼对切口痛大鼠海马胃动素表达的影响[J];中华麻醉学杂志;2016年01期
2 杨恒;宋正环;骆宏;金孝\，
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