论文部分内容阅读
目的:探讨在超声引导下肌间沟臂丛神经阻滞中应用不同浓度罗哌卡因的麻醉效果。方法:采用随机数字表法将2016年4月至2018年4月金华市中医医院行上肢骨科手术患者120例(均实施超声引导下肌间沟臂丛神经阻滞)分为甲组(40例,应用0.375%罗哌卡因)、乙组(40例,应用0.50%罗哌卡因)、丙组(40例,应用0.75%罗哌卡因)。对比三组患者的麻醉效果、感觉阻滞起效时间、运动阻滞起效时间、镇痛持续时间、运动阻滞恢复时间、血清肌钙蛋白水平、肌酸激酶同工酶水平及不良反应发生率。结果:三组患者麻醉优良率均为100.0%,差异无统计学意义(n P>0.05);丙组感觉阻滞起效时间[(5.29±1.32)min]、运动阻滞起效时间[(7.42±1.36)min]均较甲组[(9.32±1.52)min、(13.32±2.46)min]、乙组[(7.89±1.63)min、(9.12±2.20)min]短(n F=4.652、6365,均n P0.05). The onset time of sensory block[(5.29±1.32)min], the onset time of motion block[(7.42±1.36)min] in group C were shorter than those in group A[(9.32±1.52)min, (13.32±2.46)min] and group B[(7.89±1.63)min, (9.12±2.20)min](n F=4.652, 6.365, all n P<0.05). The analgesic duration in group C[(10.71±1.52)h] was longer than that in group A[(6.89±2.23)h] and group B[(8.69±2.12)h](n F=5.120, n P<0.05), but the recovery time of motion block in group C was longer than that in group A and group B (n P<0.05). The serum troponin level and creatine kinase isozyme level at 24 h after injection in group C were significantly higher than those in group A and group B(n P<0.05), and the serum troponin level and creatine kinase isozyme level in group B were significantly higher than those in group A (n P0.05).n Conclusion:With the increase of ropivacaine concentration, the onset time of anesthesia is shorter and the analgesic time is longer, but the incidence of adverse reactions is also higher.In a comprehensive consideration, 0.50% ropivacaine can be applied to patients with intermuscular sulcus brachial plexus block under ultrasound guidance.