麻醉安全与质控2025，Vol.7Issue(3)：212-216,5.DOI:10.3969/j.issn.2096-2681.2025.03.006
两种剂量的艾司氯胺酮复合罗哌卡因对肱骨骨折患者臂丛神经阻滞效果的影响
Effects of two doses of esketamine combined with ropivacaine on brachial plexus block in patients with humeral fractures
摘要
Abstract
Objective To compare the effects of two different doses of esketamine combined with ropivacaine on brachial plexus block in patients with humerus fractures.Methods Ninety patients of either gender,aged 22-69 years old,with a body weight of 50-85 kg,of American Society of Anesthesiologists(ASA)Physical Status classification Ⅰ or Ⅱ,with unilateral humeral shaft fracture who underwent open reduction and internal fixation through intermuscular groove brachial plexus block at Zibo 148th Hospital from January to December 2023 were selected as the study objects.Patients were divided into three groups by random number table method:0.5％ropivacaine 20 mL group(group R,n=30),10 mg esketamine+0.5％ropivacaine 20 mL group(group S1,n=30),20 mg esketamine+0.5％ropivacaine 20 mL group(group S2,n=30).The onset time of sensory block,onset time of motor block,duration of sensory block,duration of motor block,visual analogue scale(VAS)scores at rest and during activity at 8,10,12,24 and 48 h after surgery were recorded in the three groups.The incidence of"rebound pain"within 48 h,the number of patient controlled intravenous analgesia(PCIA)compressions,the number of remedial analgesia cases,and the satisfaction of postoperative analgesia were recorded.The occur-rence of postoperative adverse reactions was observed.Results Compared with group R,the onset time of sensory block and motor block in group S1 and group S2 were faster and the duration were longer(P＜0.05).Patients in the group S1 and group S2 had lower VAS scores at rest and activity at 8,10,and 12 h postoperatively than those in the group R(P＜0.05).The incidence of"rebound pain",the number of PCIA compressions,and the number of cases of tramadol rescue analgesia in group R patients within 48 h after surgery were higher than those in group S1 and group S2(P＜0.05);the incidence of adverse reactions in group S1 was lower than that in group S2(P＜0.05).Conclusion A 10 mg dose of esketamine can shorten the onset time of brachial plexus block,prolong the postoperative analgesic duration,decrease the occurrence of"rebound pain",and is associated with fewer postoperative adverse effects,and has a rela-tively high satisfactron rate in pain relief.关键词
肱骨骨折/臂丛神经阻滞/艾司氯胺酮/罗哌卡因Key words
humeral fractures/brachial plexus block/esketamine/ropivacaine引用本文复制引用
吴健,周凯..两种剂量的艾司氯胺酮复合罗哌卡因对肱骨骨折患者臂丛神经阻滞效果的影响[J].麻醉安全与质控,2025,7(3):212-216,5.基金项目
中国红十字基金会医学赋能公益专项基金(CRCF-YXFN-202401056) （CRCF-YXFN-202401056）
