小劑量納洛酮復(fù)合羅哌卡因或舒芬太尼—羅哌卡因?qū)Ρ蹍沧铚挠绊?/H1>
發(fā)布時(shí)間：2018-08-10 07:58
【摘要】：目的:評(píng)價(jià)小劑量納洛酮復(fù)合羅哌卡因或舒芬太尼-羅哌卡因混合液對(duì)超聲引導(dǎo)下臂叢阻滯的影響。方法:選擇我院行上肢手術(shù)的患者100例,將其隨機(jī)分為四組,每組25例。0.375%甲磺酸羅哌卡因20ml(D組);0.375%甲磺酸羅哌卡因+10μg舒芬太尼共20ml(S組);0.375%甲磺酸羅哌卡因+100ng納洛酮共20ml(N組);0.375%甲磺酸羅哌卡因+10μg舒芬太尼+100ng納洛酮共20ml(N+S組)。所有患者均在超聲引導(dǎo)下行肌間溝臂叢神經(jīng)阻滯麻醉,觀察并記錄給藥后5min、15min、30min、6h、12h、18h、24h手術(shù)區(qū)域感覺阻滯情況、運(yùn)動(dòng)阻滯情況及不良反應(yīng)情況。結(jié)果:D組的感覺阻滯持續(xù)時(shí)間及運(yùn)動(dòng)阻滯持續(xù)時(shí)間分別為(435.5±77.9min)及(350.2±69.8min),S組為(831.7±52.0min)及(675.8±48.1min),N組為(933.0±117.1min)及(499.0±40.5min),N+S組為(919.3±59.0min)及(534.8±56.6min)。四組患者性別比例、年齡、身高、體重、BMI、ASA分級(jí)差異均無統(tǒng)計(jì)學(xué)意義。N組和N+S組的感覺阻滯持續(xù)時(shí)間比D組和S組長(P0.05)。D組的感覺阻滯持續(xù)時(shí)間及運(yùn)動(dòng)阻滯持續(xù)時(shí)間比其他組短(P0.05)。所有組的感覺阻滯起效時(shí)間和運(yùn)動(dòng)阻滯起效時(shí)間差異無統(tǒng)計(jì)學(xué)意義。給藥后5 min、24 h四組患者的VAS疼痛評(píng)分差異無統(tǒng)計(jì)學(xué)意義。給藥后6h、12 h,D組的VAS疼痛評(píng)分明顯高于S組、N組和N+S組(P0.05)。給藥后18 h,D組和S組的VAS疼痛評(píng)分明顯高于N組和N+S組(P0.05)。四組患者均未出現(xiàn)頭暈、惡心嘔吐、嗜睡、皮膚瘙癢、局麻藥毒性反應(yīng)、呼吸抑制等不良反應(yīng)。結(jié)論:添加小劑量納洛酮(100ng)于0.375%的羅哌卡因中用于臂叢神經(jīng)阻滯麻醉,有或沒有舒芬太尼,可以延長感覺和運(yùn)動(dòng)阻滯的持續(xù)時(shí)間,有效降低術(shù)后疼痛,有助于患者術(shù)后早日進(jìn)行功能鍛煉,且未增加不良反應(yīng),安全可靠,是一種安全、有效的神經(jīng)阻滯方法,值得臨床推廣運(yùn)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 鹵77.9min) and (350.2 鹵69.8min) vs (831.7 鹵52.0min) and (675.8 鹵48.1min) in group N and (933.0 鹵117.1min), (919.3 鹵59.0min) and (534.8 鹵56.6min) in group N and (499.0 鹵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.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R614
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 趙軍;劉國強(qiáng);高寶柱;鄭寶森;曹君利;魯顯福;劉功儉;;鞘內(nèi)注射小劑量納洛酮、嗎啡和芬太尼對(duì)切口痛大鼠海馬胃動(dòng)素表達(dá)的影響[J];中華麻醉學(xué)雜志;2016年01期
2 楊恒;宋正環(huán);駱宏;金孝\，
本文編號(hào)：2175448
本文鏈接：http://sikaile.net/yixuelunwen/mazuiyixuelunwen/2175448.html
[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 鹵77.9min) and (350.2 鹵69.8min) vs (831.7 鹵52.0min) and (675.8 鹵48.1min) in group N and (933.0 鹵117.1min), (919.3 鹵59.0min) and (534.8 鹵56.6min) in group N and (499.0 鹵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.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R614
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 趙軍;劉國強(qiáng);高寶柱;鄭寶森;曹君利;魯顯福;劉功儉;;鞘內(nèi)注射小劑量納洛酮、嗎啡和芬太尼對(duì)切口痛大鼠海馬胃動(dòng)素表達(dá)的影響[J];中華麻醉學(xué)雜志;2016年01期
2 楊恒;宋正環(huán);駱宏;金孝\，
本文編號(hào)：2175448
本文鏈接：http://sikaile.net/yixuelunwen/mazuiyixuelunwen/2175448.html
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