甲磺酸罗哌卡因联合曲马多在腋路臂丛神经阻滞中的应用

发布时间：2018-12-14 20:18

【摘要】：目的：评价甲磺酸罗哌卡因、甲磺酸罗哌卡因和曲马多两药联合应用的安全性和有效性，为临床提供合理、安全、满意的麻醉效果。方法：选择2013年12月－2014年8月沈阳医学院附属中心医院麻醉科34例行择期上肢手术患者，ASA分级I~II级，年龄18-50岁，体重45-90kg，患者无臂丛神经阻滞的禁忌症。将病人随机分成2组（A组18例，B组16例），A组：0.596%甲磺酸罗哌卡因40ml，B组：0.596%甲磺酸罗哌卡因，曲马多100mg共40ml，两组进行同样的麻醉操作，比较两组观察指标的变化。结果：两组病例的性别、年龄、体重经统计学分析均无统计学意义。麻醉前、后生命体征（BP、HR、SpO2、SBP）无统计学意义（P0.05），两组DBP在麻醉20分时的差异有统计学意义(P0.05)，其他时刻均无统计学意义。两组的BP和SpO2组间比较无统计学意义（P0.05），，心率的组间比较有统计学意义(P0.05)。B组感觉阻滞起效时间（1.94±0.77）min，A组感觉阻滞起效时间（4.22±1.70）min，组间比较差异有统计学意义(P0.001)，B组感觉阻滞起效时间较短。B组运动阻滞起效时间（3.69±0.95）min，A组运动阻滞起效时间（7.00±2.40）min，组间比较差异有统计学意义(P0.001)，B组运动阻滞起效时间较短。结论: 1.不同时间点单独使用甲磺酸罗哌卡因与联合使用甲磺酸罗哌卡因、曲马多两组在进行腋路臂丛神经阻滞麻醉过程中，血压、心率、血氧饱和度的变化均无差异，说明麻醉过程中是安全的。 2.单独使用甲磺酸罗哌卡因，联合使用甲磺酸罗哌卡因、曲马多进行腋路臂丛神经阻滞麻醉时，血压和血氧饱和度组间无差异。 3.单独使用甲磺酸罗哌卡因进行腋路臂丛神经阻滞麻醉时不同时间心率均高于联合使用甲磺酸罗哌卡因、曲马多进行腋路臂丛神经阻滞麻醉时心率； 4.单独使用甲磺酸罗哌卡因进行腋路臂丛神经阻滞麻醉感觉阻滞起效时间和运动阻滞起效时间均显著高于联合使用甲磺酸罗哌卡因、曲马多。
[Abstract]:Objective: to evaluate the safety and efficacy of ropivacaine mesylate, ropivacaine mesylate and tramadol in clinical anesthesia. Methods: from December 2013 to August 2014, 34 patients in Department of Anesthesiology, affiliated Hospital of Shenyang Medical College, with ASA grade I~II, aged 18-50 years, weight 45-90 kg, had no contraindication of brachial plexus block. Patients were randomly divided into two groups: group A (n = 18), group B (n = 16), A: 0.596% ropivacaine mesylate (n = 16): group B: 0.596% ropivacaine mesylate (n = 20) and tramadol 100mg (n = 40). The changes of observation indexes were compared between the two groups. Results: there was no significant difference in sex, age and body weight between the two groups. Before anesthesia, after the vital signs (BP,HR,SpO2,SBP) had no statistical significance (P0.05), the two groups of DBP in anesthesia at 20 hours of the difference was statistically significant (P0.05), no statistical significance at other times. There was no significant difference in BP and SpO2 between the two groups (P0.05), but there was significant difference in heart rate (P0.05) in the). B group (P0.05) the onset time of sensory block was (1.94 卤0.77) min,. The onset time of sensory block in group A was (4.22 卤1.70) min, the onset time of sensory block in group B was (3.69 卤0.95) min, that of group B was (3.69 卤0.95) min,. The onset time of motor block in group A was (7. 00 卤2. 40) min, (P 0. 001), B). The onset time of motor block in group A was shorter than that in group A (P 0. 001 卤2. 40). Conclusion: 1. There was no difference in blood pressure, heart rate and oxygen saturation between tramadol group and ropivacaine mesylate group during axillary brachial plexus block anesthesia at different time points. It shows that it is safe during anesthesia. 2. When ropivacaine mesylate was used alone, ropivacaine mesylate combined with tramadol for axillary brachial plexus block, there was no difference between blood pressure and oxygen saturation. 3. The heart rate of ropivacaine mesylate alone in axillary brachial plexus block anesthesia was higher than that of combined ropivacaine mesylate group and tramadol in axillary brachial plexus block anesthesia. 4. The onset time of sensory block and motor block in axillary brachial plexus block with ropivacaine mesylate alone was significantly higher than that with ropivacaine mesylate and tramadol.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614.4

【参考文献】