布比卡因加入地塞米松对蛛网膜下腔神经阻滞麻醉下行下肢手术患者神经阻滞时效的影响

发布时间：2018-08-31 15:41

【摘要】：目的探讨布比卡因加入地塞米松对蛛网膜下腔神经阻滞麻醉(腰麻)下行下肢手术患者神经阻滞时效的影响。方法选取南京市江宁医院2015年12月—2016年9月择期行腰麻下下肢手术患者90例,根据腰麻使用药物和给药方式不同将患者分为C组、D1组和D2组,各30例。C组蛛网膜下腔注入布比卡因10 mg;D1组蛛网膜下腔注入布比卡因10 mg+地塞米松粉剂5 mg;D2组蛛网膜下腔注入布比卡因10 mg,同时蛛网膜下腔注入地塞米松5 mg。比较3组患者神经阻滞情况,即麻醉最高阻滞平面(胸)、麻醉起效时间(T_1)、达最高平面时间(T_2)、感觉阻滞持续时间(T_3)及术后镇痛持续时间(T_4)、运动阻滞持续时间至运动恢复的时间(T_5),手术时间、术中出血量、补液量及不良反应发生情况。结果 3组患者阻滞最高平面(胸)、T_1、T_2比较,差异无统计学意义(P0.05);D1组T_3、T_4长于C组、D2组(P0.05);C组与D2组T_3、T_4比较,差异无统计学意义(P0.05),3组患者T_5比较,差异无统计学意义(P0.05)。3组患者手术时间、术中出血量、补液量及不良反应发生率比较,差异无统计学意义(P0.05)。结论布比卡因加入地塞米松可延长腰麻下行下肢手术患者感觉阻滞时间和术后镇痛持续时间及不影响运动阻滞持续时间,且不良反应少。
[Abstract]:Objective to investigate the effect of bupivacaine and dexamethasone on the time of nerve block in patients undergoing lower extremity operation under subarachnoid nerve block (spinal anesthesia). Methods from December 2015 to September 2016, 90 patients undergoing lower extremity surgery under spinal anesthesia in Jiangning Hospital of Nanjing City were selected and divided into group C (group D 1) and group D 2 (group D 2). Subarachnoid injection of bupivacaine 10 mg;D1 subarachnoid injection of bupivacaine 10 mg dexamethasone powder 5 mg;D2 group subarachnoid injection of bupivacaine 10 mg, and subarachnoid injection of dexamethasone 5 mg. To compare the nerve block in three groups, That is, the maximum block level (chest), the onset time of anesthesia (TCI 1), the time of reaching the maximum level (T _ 2), the duration of sensory block (T _ 3), the duration of postoperative analgesia (T _ 4), the duration of motor block to motor recovery (T _ 5), the time of operation, and the amount of intraoperative bleeding. Fluid rehydration and adverse reactions. Results there was no significant difference in T _ 1C _ 1 and T _ S _ 2 between the three groups (P0.05). The T3T _ 4 in the D _ 1 group was longer than that in the D _ 2 group (P 0.05), and there was no significant difference between the C group and D _ 2 group (P 0.05). The difference was not statistically significant (P0.05). There was no significant difference in the time of operation, the amount of intraoperative bleeding, the amount of fluid rehydration and the incidence of adverse reactions (P0.05). Conclusion Bupivacaine and dexamethasone can prolong the sensory block time, postoperative analgesia duration and motor block duration in patients undergoing lower extremity surgery under spinal anesthesia, and have less adverse reactions.
【作者单位】：南京市江宁医院麻醉科;
【基金】：南京市江宁区科技发展计划(2015Eg06)
【分类号】：R614

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