浙江医学Issue(23)：2103-2106,4.
超声引导锁骨上臂丛阻滞不同浓度罗哌卡因对膈肌移动度的影响
Effects of Different Concentrations of Ropivacaine on Diaphragmatic Excursion in Supraclavicular Brachial Plexus Block under Ultrasound Guidance
丁朝梁 1王权光 2倪建武 3张学政 2陈丽梅 2张裕坚 2Chenggang Hu 4徐旭仲2
作者信息
- 1. 325400 平阳县人民医院麻醉科
- 2. 温州医学院附属第一医院麻醉科
- 3. 温州市第八人民医院麻醉科
- 4. 美国加利福尼亚Palo-mar医学中心麻醉科
- 折叠
摘要
Abstract
Objective To investigate the effects of different concentrations of ropivacaine in supraclavicular brachial plexus block (SBPB) under ultrasound guidance on ipsilateral diaphragmatic excursion and anesthetic efficacy. Methods Thirty ASAⅠ~Ⅱpatients scheduled for the upper extremity surgery were randomized into three groups by drawing lots (n=10 in each group). SBPB were performed with ropivacaine 20 ml, with the concentrations of 0.5% (Group A), 0.375% (Group B) and 0.25%(Group C), respectively. The ipsilateral diaphragmatic excursions of the patients under eupnea were measured with the high fre-quency ultrasonography before and after SBPB. Otherwise, the onset times and the clinical efficacy of SBPB were also observed. Results The onset times of anesthesia in Group A were the shortest, while those in Group C were the longest (P<0.01). The effi-cacy of nerve block and anesthetic potency in Group C were worse than those in other two groups (P<0.05). In Group A, the ex-tent of diaphragmatic excursion was significantly reduced during 10~90 mins after SBPB, with five patients whose diaphragma were completely paralysed. The extent of diaphragmatic excursion in Group B and Group C were significantly decreased during 10~30 mins and 10~20 mins after SBPB, respectively, with no case of complete diaphragma paralysis. After SBPB, the extent of diaphragmatic excursion in Group C was significantly lower than those in Group B and Group C (P<0.01). Conclusion Supra-clavicular brachial plexus block under ultrasound guidance using 0.375%ropivacaine is an appropriate choice, with less change in the diaphragmatic excursion, shorter onset time and better anesthetic efficacy.关键词
超声/臂丛/神经阻滞/膈肌移动度/麻醉效果Key words
Ultrasound/Brachial plexus/Nerve block/Diaphragmatic excursion/Anesthetic effect引用本文复制引用
丁朝梁,王权光,倪建武,张学政,陈丽梅,张裕坚,Chenggang Hu,徐旭仲..超声引导锁骨上臂丛阻滞不同浓度罗哌卡因对膈肌移动度的影响[J].浙江医学,2013,(23):2103-2106,4.
