地塞米松复合左旋布比卡因对臂丛神经阻滞时间影响.docVIP

地塞米松复合左旋布比卡因对臂丛神经阻滞时间影响 　　摘要：目的探讨地塞米松复合左旋布比卡因对臂丛神经阻滞时间的影响。方法选择60例上肢骨折固定手术患者，分为A、B两组，每组30例：A组注入0.375%左旋布比卡因30ml，B组注入0.375%左旋布比卡因30ml含地塞米松5mg。观察麻醉起效时间及感觉、运动阻滞持续时间。结果两组患者麻醉起效时间、运动阻滞持续时间差异均无统计学意义。B组的感觉阻滞时间明显长于A组（P0.05）。结论0.375%左旋布比卡因30ml中加入5mg地塞米松可以显著延长感觉神经阻滞的时间。 　　关键词：地塞米松；左旋布比卡因；臂丛神经阻滞 　　Effect of Dexamethasone Combined Levobupivacaine in Brachial Plexus Block Anesthesia Time 　　CHEN Shu-jun1,HUANG Jie-ying1,SHEN Chun-xia2,FENG Yong-chun1 　　(1.Department of Anesthesiology,Shangcai County Peoples Hospital,Shangcai 463800,Henan,China;2.Shangcai County Xiehe Hospital,Shangcai 463800,Henan,China) 　　Abstract：ObjectiveTo investigate the effect of dexamethasone combined levobupivacaine in brachial plexus block of time. Methods60 cases of upper extremity fracture fixation operation patients, randomly divided into A, B two groups: A group with 0.375% levobupivacaine 30ml, B group were injected with 0.375% levobupivacaine 30ml dexamethasone 5mg. To observe the onset time of anesthesia and sensory, motor block duration. ResultsThe two groups of patients the onset time, duration of motor block were not statistically significant. B group of sensory block time was significantly longer than those of group A (P0.05). Conclusion Adding 5mg dexamethasone 0.375% levobupivacaine 30ml can significantly prolong the time of sensory nerve block. 　　Key words：Dexamethasone;Left Bbu Be Kain; Brachial plexus block 　　臂丛神经阻滞麻醉操作简单、效果确切，为上肢骨折手术的首选。以往臂丛神经阻滞多采用单一局麻药。文献报道地塞米松可以延长布比卡因阻滞时间[1]。近年来我科臂丛神经阻滞的局麻药采用左旋布比卡因，本研究在左旋布比卡因中加入地塞米松，观察地塞米松在臂丛神经阻滞中对左旋布比卡因阻滞时间的影响。 　　1资料与方法 　　1.1一般资料60例择期行肱骨、挠骨、尺骨骨折固定手术患者，ASAⅠ或Ⅱ级，男48例，女12例，年龄18~62岁，体重50~79kg，患者术前无中枢神经系统疾病、认知功能障碍、臂丛神经损伤、出凝血功能障碍、糖尿病、心肺肝肾功能不全、长期苯二氮卓类药物或阿片类药物用药史。排除阻滞不全，术中需用辅助静脉麻醉药的患者。患者分为0.375%左旋布比卡因30ml（A组）和0.375%左旋布比卡因30ml含地塞米松5mg组（B组）。 　　1.2方法所有患者麻醉前30min肌肉注射苯巴比妥钠0.1g、阿托品0.5mg。患者入室后开放外周静脉，常规进行ECG、BP、和SpO2监测。两组患者行肌间沟臂丛神经阻滞，患者出现异感后，注射器回抽无血注入局麻药，A组注入0.375%左旋布比卡因30ml，B组注入0.375%左旋布比卡因30ml含地塞米松5mg。术后不使用止痛药物。 　　1.3观察指标观察挠神经、正中神经、尺神经肌力评估运动阻滞，采用Lovett分级