不同浓度罗哌卡因在连续臂丛神经阻滞下对肩关节镜术后快速康复的影响.docxVIP

不同浓度罗哌卡因在连续臂丛神经阻滞下对肩关节镜术后快速康复的影响 　　【摘要】目的：探讨不同浓度罗哌卡因在连续臂丛神经阻滞下对肩关节镜术后快速康复的疗效。方法：选取2018年3月-2019年2月在笔者所在医院行肩关节镜手术治疗的118例肩袖受损患者，按照随机数字表法分为a组（59例）和b组（59例）。两组均予以肌间沟臂丛神经置管联合全身麻醉，a组罗哌卡因浓度为0.375%，b组浓度为0.20%。比较两组在肩关节镜术后的麻醉效果。结果：b组患者丙泊酚、七氟烷和瑞芬太尼等麻醉药物剂量均与a组比较，差异均无统计学意义（p0.05）;b组术后1、6、12、24、48h疼痛vas评分与a组比较，差异均无统计学意义（p0.05）;b组患者术后1、6、12、24、48h前臂运动评分均明显低于a组，差异均有统计学意义（p0.05）;b组患者术后48h精神状态和镇静评分明显优于a组，差异均有统计学意义（p0.05）;两组患者手术麻醉期间和术后均未见不良反应发生。结论：0.375%与0.20%罗哌卡因在连续臂丛神经阻滞中均有良好效果，但0.20%罗派卡因术后前臂运动恢复更快及精神状态越佳。 　　【关键词】罗哌卡因不同浓度连续臂丛神经阻滞肩关节镜术后快速康复 　　[abstract]objective：toexploretheeffectofdifferentconcentrationofropivacaineonrapidrehabilitationaftershoulderarthroscopyundercontinuousbrachialplexusblock.method：atotalof118patientswithrotatorcuffinjurywhounderwentarthroscopicshouldersurgeryinourhospitalfrommarch2018tofebruary2019weredividedintogroupa（59cases）andgroupb（59cases）accordingtorandomnumbertablemethod.bothgroupsweregivenintermuscularsulcusbrachialplexuscatheterizationcombinedwithgeneralanesthesia.ingroupa，patientsweregiven0.375%ropivacaine.ingroupb，patientsweregiven0.20%ropivacaine.anesthesiaeffectoftwogroupsaftershoulderarthroscopywerecompared.result：therewerenosignificantdifferencesinpropofol，sevofluraneandremifentanildosagebetweengroupbandgroupa（p0.05）.therewerenosignificantdifferencesinvasscoreofpainbetweengroupbandgroupaat1，6，12，24and48hoursafteroperation（p0.05）.theforearmmotorscoresofgroupbat1，6，12，24and48hoursafteroperationweresignificantlylowerthanthoseofgroupa，thedifferenceswerestatisticallysignificant（p0.05）.thementalstateandthesedationscoreweresignificantlybetterthanthoseofgroupa，thedifferenceswerestatisticallysignificant（p0.05）.therewerenoadversereactionsduringandafteranesthesiainbothgroups.conclusion：the0.375%and0.20%ropivacainehavegoodeffectsincontinuousbrachialplexusblock，but0.20%ropivacainehasfasterrecoveryofforearmmovementandbettermentalstateafteroperation. 　　[keywords]ropivacainedifferentconcentrationscontinuousbrachialplexusblockshoulderarthroscopyrapid