Application of ultrasound-guided interscalene brachial plexus block with low concentration ropivacaine in patients with operation of upper limb fracture
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摘要: 目的 观察超声引导下低浓度罗哌卡因肌间沟臂丛神经阻滞在上肢骨折手术中的效果。 方法 将上肢骨折手术患者91例按交替分组法分为2组,均在超声引导下行罗哌卡因肌间沟臂丛神经阻滞麻醉。对照组(n=45)给予0.5%罗哌卡因麻醉阻滞,观察组(n=46)给予0.25%罗哌卡因麻醉阻滞。比较2组患者用药30 min后神经阻滞情况、麻醉相关指标及不良反应发生情况。 结果 用药30 min后, 2组桡神经、尺神经、正中神经及肌皮神经完全阻滞的患者比率比较,差异无统计学意义(P>0.05)。观察组镇痛持续时间、运动阻滞恢复时间短于对照组,差异有统计学意义(P<0.05)。观察组麻醉相关不良反应发生率为4.35%, 低于对照组的20.00%, 差异有统计学意义(P<0.05)。 结论 上肢骨折手术中采用超声引导下低浓度罗哌卡因肌间沟臂丛神经麻醉的效果好,能满足手术需求,且不良反应少。Abstract: Objective To observe the effect of ultrasound-guided interscalene brachial plexus block with low concentration ropivacaine in patients with operation of upper limb fracture. Methods Totally 91 patients with operation of upper limb fracture were selected and divided into two groups according to alternate grouping method. All the patients were anesthetized with intermuscular brachial plexus block of ropivacaine under the guidance of ultrasound. Control group(n=45)was given 0.5% ropivacaine for anesthesia block, and observation group(n=46)was given 0.25% ropivacaine for anesthesia block. The condition of nerve block, anesthesia related indexes and adverse reactions were compared between the two groups at 30 minutes after anaesthetization. Results There was no significant difference in the ratio of patients with complete blocks of radial nerve, ulnar nerve, median nerve and musculocutaneous nerve between the two groups at 30 minutes after medication use(P>0.05). The duration of analgesia and recovery time of motor block in the observation group were significantly shorter than those in the control group(P<0.05). The incidence of anesthesia related adverse reactions in the observation group was 4.35%, which was significantly lower than 20.00% in the control group(P<0.05). Conclusion Ultrasound-guided interscalene brachial plexus block with low concentration ropivacaine is effective in treatment of patients with operation of upper limb fracture, which can meet the needs of surgery and cause less adverse reactions.
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