共查询到19条相似文献,搜索用时 468 毫秒
1.
目的 观察0.596%甲磺酸罗哌卡因和0.5%盐酸罗哌卡因在超声引导下行肌间沟臂丛神经阻滞的效果.方法 60例上肢手术行肌间沟臂丛麻醉的患者,随机均分成两组:A组给予0.596%甲磺酸罗哌卡因30 ml;B组给予0.5%盐酸罗哌卡因30 ml.比较两组感觉及运动阻滞起效时间、阻滞程度、运动恢复时间、镇痛持续时间和不良反应.结果 A组尺神经感觉阻滞起效时间显著快于B组[(38.30±14.65)min vs.(48.03±22.34)min](P<0.05).注药60 min A组尺神经感觉完全阻滞29例(96.7%),显著多于B组的20例(66.7%)(P<0.05).结论 0.596%甲磺酸罗哌卡因的尺神经感觉阻滞优于0.5%盐酸罗哌卡因. 相似文献
2.
目的 观察罗哌卡因应用于臂丛神经阻滞的临床效果。方法 选择ASA Ⅰ~Ⅱ级上肢手术病人30例,随机分为三组,每组10例。分别以0.75%罗哌卡因、0.5%罗哌卡因和0.5%布比卡因采用肌间沟法进行臂丛神经阻滞,注入量20ml。分别记录病人感觉阻滞和运用阻滞的起效时间,峰值时间(达到完全阻滞可以开始手术的时间),追加阻滞药物的比率,术中病人对阿片类药物的需要,病人的满意程度等指标。对比各组间的各项指标。结果 两组罗哌卡因与0.5%布比卡因比较在注射10、15、20 min后达到完全的感觉和运动阻滞的比率较高(P<0.01)。罗哌卡因组的平均峰值时间明显短于布比卡因组(R50=16.3±3.16min,R75=14.6±3.33min,B=22.4±4.17 min,P<0.05)。根据病人术中对阿片类药的需要和全部病人的满意程度,认为罗哌卡因有较高的麻醉质量(P<0.05)。其他各项指标无显著差异。结论 罗哌卡因在臂丛神经阻滞中出现了较布比卡因平均峰值时间短、阻滞完善的优越性。在肌间沟臂丛神经阻滞中应该使用0.5%的罗哌卡因。 相似文献
3.
目的 比较左旋布比卡因和罗哌卡因用于肌间沟臂丛神经阻滞的效果及不良反应。方法 本组自2007年5月~12月对60例行上肢手术患者,ASAI~Ⅱ级,分为罗哌卡因(R)组和左旋布比卡因(L)组,每组30例,采用肌间沟法行臂丛神经阻滞,观察感觉/运动神经阻滞的起效时间及持续时间、患者对神经阻滞满意度、不良反应。结果 两组间感觉神经和运动神经阻滞起效时间的差异无显著性(P〉0.05);L组的感觉和运动神经阻滞持续时间显著长于R组(P〈0.05),神经阻滞优良率均为100%。结论 左旋布比卡因与罗哌卡因均可安全用于临床肌间沟臂丛神经阻滞,二者有相似的药效学特性,但左旋布比卡因在术后镇痛方面略优于罗哌卡因。 相似文献
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5.
目的:观察不同浓度罗哌卡因用于蛛网膜下腔阻滞的效果。方法:45例择期膝关节镜手术病人,随机分为三组,每组15例,分别于蛛网膜下腔注入0.5%布比卡因2.5ml(C组),0.5%罗哌卡因2.5ml(R1组)或0.75%罗哌卡因2.5ml(R2组)。记绿麻醉后的血压、心率、脉博血氧饱和度,感觉与运动阻滞的起效时间,达最高阻滞平面和最大阻滞程度的时间。感觉与运动阻滞的恢复时间。术后第二天随访记录术后并发症。结果:三组病人感觉阻滞起效和达到最高阻滞平面无显著性差异。感觉阻滞维持时间以0.75%罗哌卡因组与0.5%布比卡因组明显长于0.5%罗哌卡因组,而前两组间无显著性差异,运动阻滞起效时间三组组无显著性差异。运动阻滞程度及维持时间以0.5%罗哌卡因组较0.75%罗哌卡因组或0.5%布比卡因组有显著性差异。而后两组间无显著性差异。结论:蛛网膜下腔阻滞应用0.75%罗哌卡因与0.5%d布比卡因的作用相似,均可以安全使用于蛛网膜下腔阻滞麻醉。0.75%罗哌卡因可提供更完善的运动和感觉阻滞。 相似文献
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目的 观察喷他佐辛复合罗哌卡因用于臂丛神经阻滞的效果.方法 40例ASA Ⅰ或Ⅱ级,接受肌间沟臂丛神经阻滞行上肢手术的患者随机均分为:A组,0.33%罗哌卡因30 ml;B组,0.33%罗哌卡因30 ml+喷他佐辛30 mg.手术开始15、30、60 rain及术后1、6、12、24 h行VAS疼痛评分,并记录麻醉起效时间、持续时间及不良反应发生率.结果 B组感觉与运动神经阻滞起效时间明显快于A组(P<0.05),镇痛持续时间明显长于A组(P<0.05),术中、术后VAS疼痛评分低于A组(P<0.05).结论 喷他佐辛复合罗哌卡因臂丛神经阻滞可缩短阻滞起效时间,延长持续时间,改善镇痛效果. 相似文献
7.
目的观察比较不同浓度的甲磺酸罗哌卡因用于肌间沟臂丛神经阻滞施行上肢手术的麻醉效果和安全性。方法40例ASAⅠ~Ⅱ级,18~55岁拟行上肢手术病人,随机分为四组,分别用0.45%、0.3%、0.25%甲磺酸罗哌卡因和0.25%布比卡因各30 ml行肌间沟臂丛神经阻滞。注药后1、2、3、4、5、6、7、8、9、10、20、30、60 min分别对病人的感觉和运动进行评价并观察病人是否有不适症状。结果0.45%、0.3%甲磺酸罗哌卡因和0.25%布比卡因麻醉效果强于0.25%甲磺酸罗哌卡因。0.45%甲磺酸罗哌卡因术中出现2例呼吸困难。结论0.3%甲磺酸罗哌卡因与其他各组比较,在肌间沟臂丛神经阻滞具有起效快、作用完善、不良反应少的特点,为临床适用的适宜剂量。 相似文献
8.
刘坤 《中华显微外科杂志》2010,33(1)
目的 探讨罗哌卡因用于断指再植手术肌间沟臂丛神经阻滞的效应.方法 对2008年3月至9月,分别用0.50%的罗哌卡因和0.375%的布比卡因25 ml行肌间沟臂丛神经阻滞进行的断指再植手术72例进行分析.结果 罗哌卡因对感觉神经阻滞的起效时间明显缩短,维持时间明显延长,对运动神经阻滞的起效时间和维持时间均明显缩短,毒副作用与并发症明显减少.结论 罗哌卡因用于断指再植手术肌间沟臂丛神经阻滞麻醉比布比卡因起效迅速、镇痛持续时间长,麻醉效果满意. 相似文献
9.
目的讨论不同稀释液对甲磺酸罗哌卡因臂丛麻醉的影响。方法 90例ASA1~3级的择期或急诊行上肢桡侧为主要手术区域的患者,随机分为2组,N组(0.894%甲磺酸罗哌卡因20ml+生理盐水10ml)和G组(0.894%甲磺酸罗哌卡因20ml+5%葡萄糖10ml),行肌间沟路臂丛麻醉,观察患者术中生命体征的变化,记录各组病例感觉运动阻滞起效、恢复时间,围术期局麻药不良反应及麻醉相关并发症。结果两组患者臂丛阻滞起效后BP、HR有所下降,但均未达到需要处理程度。臂丛阻滞效果佳,无1例患者需要改为全麻,N组有3例,G组4例患者在术中因不能耐受上臂止血带需要追加静脉镇痛药物;感觉与运动阻滞起效时间时间,G组快于N组,差异具有统计学意义(P<0.05),而两组的感觉运动恢复时间并无明显区别。两组患者围术期无明显局麻药物不良反应及麻醉相关并发症。结论使用5%葡萄糖稀释甲磺酸罗哌卡因行臂丛麻醉,感觉和运动阻滞的起效时间有所缩短,而未影响术后的镇痛时长,有利于繁忙的临床工作。 相似文献
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目的观察超声引导锁骨上臂丛神经阻滞(supraclavicular brachial plexus block,SCBPB)使用相同浓度不同容量罗哌卡因对膈肌麻痹的影响。方法选择拟行右上肢骨折术后取内固定装置术的患者72例,男32例,女40例,年龄18~65岁,ASA I或II级。随机分为两组:0.375%罗哌卡因20ml组(A组)和0.375%罗哌卡因30ml(B组),每组36例。所有患者在超声引导下行锁骨上臂丛神经阻滞,记录臂丛各主要神经根的感觉阻滞、运动阻滞的起效时间和持续时间,并观察两组患者不良反应的发生情况。采用M型超声测量阻滞前、阻滞后30min时两组平静呼吸和用力呼吸的膈肌移动度,通过观察膈肌移动度的变化来反映膈肌麻痹情况,并计算膈肌麻痹率。结果两组患者感觉阻滞起效时间、感觉阻滞和运动阻滞持续时间差异均无统计学意义。B组运动阻滞起效时间明显短于A组(P0.05)。阻滞后30min A组和B组分别有12例(33.3%)和22例(61.1%)患者出现膈肌麻痹,B组膈肌麻痹率明显高于A组(P0.05)。结论 0.375%罗哌卡因20 ml与30ml在超声引导下行锁骨上臂丛神经阻滞均可达到理想的臂丛阻滞效果,0.375%罗哌卡因20 ml引起膈肌麻痹较少。 相似文献
11.
Fernández-Guisasola J Andueza A Burgos E Plaza A Porras MC Reboto P Rivera JC del Valle SG 《Acta anaesthesiologica Scandinavica》2001,45(8):967-970
BACKGROUND: The purpose of this study was to compare anesthetic efficacy and postoperative analgesia of 0.5% ropivacaine and 1% mepivacaine for sciatic nerve block in the popliteal fossa (popliteal block). METHODS: A prospective, double-blind study was carried out in 58 adult patients scheduled for outpatient foot or ankle surgery. They were randomized to receive popliteal block with 40 ml of either 0.5% ropivacaine (group R) or 1% mepivacaine (group M). An atraumatic, Teflon-coated needle connected to a neurostimulator was used to make a single puncture using a posterior approach. The times to onset of sensory and motor block, and the need for intraoperative sedation were recorded. Before discharge, patients were asked to document the time to first analgesic use, time to return of full sensation in the foot, and their evaluation of the technique. RESULTS: Onset time (mean+/-standard deviation, 95% confidence interval) of both sensory block (6.5+/-5.1 min, 4.47-8.49, in group R and 6.2+/-3.7 min, 4.83-7.69, in group M) and motor block (6.6+/-4.4 min, 4.81-8.23, in group R and 7.9+/-4.1 min, 6.29-9.53, in group M) was similar in both groups. Postoperative analgesia lasted longer in group R (15.2+/-5.1 h, 13.25-17.21) than in group M (5.7+/-1.8 h, 5.01-6.41; P<0.001). Duration of sensory block was longer in group R (20.7+/-6.2 h, 18.51-23.01) than in group M (6.5+/-1.7 h, 5.86-7.16; P<0.001). Acceptance of the anesthetic procedure was similar in both groups. CONCLUSION: In this study we demonstrated that both 0.5% ropivacaine and 1% mepivacaine for popliteal block produced rapid, effective and safe anesthesia but postoperative analgesia was more long-lasting with ropivacaine. 相似文献
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Erlacher W Schuschnig C Orlicek F Marhofer P Koinig H Kapral S 《Acta anaesthesiologica Scandinavica》2000,44(1):53-57
INTRODUCTION: The new long-acting local anesthetic ropivacaine is a chemical congener of bupivacaine and mepivacaine. The admixture of clonidine to local anesthetics in peripheral nerve block has been reported to result in a prolonged block. The aim of the present study was to evaluate the effects of clonidine added to ropivacaine on onset, duration and quality of brachial plexus block. METHODS: Patients were randomly allocated into two groups. In group I brachial plexus was performed using 40 ml of ropivacaine 0.75% plus 1 ml of NaCL 0.9%, and in group II brachial plexus was performed using 40 ml of ropivacaine 0.75% plus 1 ml (0.150 mg) of clonidine. Onset of sensory and motor block of radial, ulnar, median and musculocutaneous nerve were recorded. Motor block was evaluated by quantification of muscle force, according to a rating scale from 6 (normal contraction force) to 0 (complete paralysis). Sensory block was evaluated by testing response to a pinprick in the associated innervation areas. Finally, the duration of the sensory block was registered. Data were expressed in mean+/-SD. For statistical analysis a Student t-test was used. A P-value of < or = 0.05 was considered as statistically significant. RESULTS: The duration of blockade was without significant difference between the groups. Group I: 718+/-90 min; Group II: 727+/-117 min. There was no intergroup difference in sensory and motor onset or in quality of blockade. CONCLUSION: The addition of clonidine to ropivacaine 0.75% does not lead to any advantage of block of the brachial plexus when compared with pure ropivacaine 0.75%. 相似文献
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目的观察三种浓度的盐酸甲哌卡因用于下肢手术患者腰丛阻滞的临床效果和安全性。方法选择择期行单侧膝关节镜手术的成年患者75例,ASAⅠ~Ⅱ级,根据局麻药浓度的不同,分0.25%组、0.5%组和0.75%组,每组25例。三组均在超声和神经刺激仪引导下行单侧腰丛阻滞,分别注入浓度为0.25%、0.5%、0.75%的盐酸甲哌卡因35 mL。观察腰丛阻滞的起效时间、持续时间、阻滞范围和并发症的发生情况。结果 0.25%组、0.5%组、0.75%组的感觉阻滞起效时间分别为23.7±3.8 min、15.5±3.4 min、10.2±3.1 min,组间两两比较有统计学差异(P0.01)。0.75%组感觉阻滞和运动阻滞的持续时间长于0.5%组(P0.01),运动阻滞的起效时间快于0.5%组(P0.01)。0.75%组和0.5%组的阻滞范围评分大于0.25%组(P0.05),0.75%、0.5%组之间无统计学差异。0.75%、0.5%两组均在神经阻滞下完成手术;0.25%组的阻滞效果不佳,有11例患者(44%)需改为全身麻醉才完成手术。三组患者均未出现局麻药全身中毒、硬膜外阻滞、术后神经功能障碍等并发症。结论盐酸甲哌卡因可安全有效地用于成年患者腰丛阻滞,0.5%~0.75%的浓度可获得满意的阻滞效果。 相似文献
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Bertini L Tagariello V Mancini S Ciaschi A Posteraro CM Di Benedetto P Martini O 《Regional anesthesia and pain medicine》1999,24(6):514-518
BACKGROUND AND OBJECTIVES: Although ropivacaine has been extensively studied for epidural anesthesia, very few reports exist on brachial plexus block. We therefore decided to investigate the clinical features of axillary brachial plexus anesthesia with two different concentrations of ropivacaine (0.5% and 0.75%) and to compare the results with those obtained with 0.5% bupivacaine. METHODS: Three groups of patients were randomized and prospectively studied. They received, in a double-blind fashion, 32 mL of the local anesthetic solution into the midaxilla, by a nerve-stimulator technique. Onset time in each of the stimulated nerves was recorded both for the sensory and motor block. Peak time (ready to surgery), rate of supplemental blocks, need for intraoperative opioids, duration of sensory and motor block, postoperative analgesic requirements, and patient satisfaction were also recorded. RESULTS: The rate of complete sensory and motor block observed with both ropivacaine groups was higher at 10, 15, and 20 minutes postinjection (P < .001). The mean peak time was shorter with ropivacaine than with bupivacaine (R50 = 16.37 minutes, R75 = 14.7 minutes, B = 22.3 minutes, P < .05). The quality of the anesthesia was higher with ropivacaine, as measured by the intraoperative needs for opioids and the overall patient's satisfaction (P < .05). No significant differences were noted with all the other studied parameters. CONCLUSION: Ropivacaine showed advantages over bupivacaine for axillary brachial plexus block. Because no statistical differences were found between the two ropivacaine groups, we therefore conclude that 0.75% does not add benefit and that 0.5% ropivacaine should be used to perform axillary brachial plexus blocks. 相似文献
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Interscalene brachial plexus anaesthesia with 0.5%, 0.75% or 1% ropivacaine: a double-blind comparison with 2% mepivacaine 总被引:1,自引:0,他引:1
Casati A Fanelli G Aldegheri G Berti M Colnaghi E Cedrati V Torri G 《British journal of anaesthesia》1999,83(6):872-875
We have compared interscalene brachial plexus block performed with
ropivacaine or mepivacaine in 60 healthy patients undergoing elective
shoulder surgery. Patients were allocated randomly to receive interscalene
brachial plexus anaesthesia with 20 ml of 0.5% ropivacaine (n = 15), 0.75%
ropivacaine (n = 15), 1% ropivacaine (n = 15) or 2% mepivacaine (n = 15).
Readiness for surgery (loss of pinprick sensation from C4 to C7 and
inability to elevate the limb from the bed) was achieved sooner with 1%
ropivacaine (mean 10 (SD 5) min) than with 0.5% ropivacaine (22 (7) min) (P
< 0.001) or 2% mepivacaine (18 (9) min) (P < 0.02). Postoperative
analgesia was similar with the three ropivacaine concentrations (11.5 (5)
h, 10.7 (2) h and 10 (2.4) h with 0.5%, 0.75% and 1% concentrations,
respectively) and nearly two-fold longer compared with 2% mepivacaine (5.1
(2.7) h) (P < 0.001).
相似文献
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Taboada M Cortés J Rodríguez J Ulloa B Alvarez J Atanassoff PG 《Regional anesthesia and pain medicine》2003,28(6):516-520
BACKGROUND AND OBJECTIVES: Ropivacaine and mepivacaine are commonly used local anesthetics for peripheral nerve blockade. The purpose of the present study was to compare onset time, quality of anesthesia, and duration of analgesia with ropivacaine 0.75% and mepivacaine 1.5% for lateral popliteal nerve block. METHODS: Fifty American Society of Anesthesiologists (ASA) physical status I or II patients scheduled for foot and ankle surgery with calf tourniquet under lateral popliteal sciatic nerve block were randomly assigned to receive 30 mL of either ropivacaine 0.75% or mepivacaine 1.5%. Time required for onset of sensory and motor block, resolution of motor blockade, onset of postsurgical pain, and time of first analgesic medication were recorded. RESULTS: The 2 groups were similar with regard to demographic variables and duration of surgery. Onset of sensory and motor block was significantly shorter in the mepivacaine group (9.9 +/- 3.3 min and 14.7 +/- 3.6 min, respectively) than in the ropivacaine group (18.1 +/- 6.1 min and 23.6 +/- 5.5 min, respectively) (P < 0.001). Resolution of motor block occurred later in the ropivacaine group than in the mepivacaine group (P < 0.001), and duration of postoperative analgesia was significantly longer in the ropivacaine group (19 +/- 3.4 h) compared with the mepivacaine group (5.9 +/- 1.1 h) (P < 0.001). Analgesic requirements were higher in mepivacaine group than in the ropivacaine group (P < 0.001). There were 2 failed blocks, one in each group. CONCLUSIONS: Both ropivacaine and mepivacaine provided effective sciatic nerve blockade. Mepivacaine 1.5% displayed a significantly shorter onset time than ropivacaine 0.75%. Postoperatively, ropivacaine 0.75% resulted in longer-lasting analgesia and less need for oral pain medication. 相似文献
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目的 比较右美托咪定和地塞米松混合于罗哌卡因用于腰丛阻滞的临床效果。方法 选择单侧膝部或股骨手术的成年患者90例,ASAⅠ或Ⅱ级,随机分为三组:对照组、地米组和右美组,每组30例。三组患者均在超声联合神经刺激仪引导下行后路腰丛阻滞,对照组注入浓度为0.375%(3.75 mg/mL)的盐酸罗哌卡因0.5 mL/kg,地米组注入相同浓度、等效容量的局麻药和地塞米松0.1 mg/kg,右美组注入相同浓度、等效容量的局麻药和右美托咪定1 μg/kg。比较感觉、运动阻滞的起效时间和持续时间,记录术后24 h内VAS疼痛评分和镇痛药用量,观察并发症的发生情况。结果 感觉和运动阻滞的起效时间:右美组<地米组<对照组(P<0.05);感觉和运动阻滞的持续时间:右美组>地米组>对照组(P<0.05)。地米组和右美组术后24 h的VAS疼痛评分低于对照组(P<0.05);地米组和右美组术后24 h内的镇痛药用量少于对照组(P<0.05),右美组少于地米组(P<0.05)。三组患者并发症的发生率无统计学差异。结论 右美托咪定或地塞米松与罗哌卡因混合应用均能加快腰丛阻滞的起效时间、延长持续时间和降低患者术后疼痛程度,但右美托咪定的作用更为显著。 相似文献
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Jeff Gadsden MD Admir Hadzic MD PhD Kishor Gandhi MD MPH Ali Shariat MD Daquan Xu MB MPH Thomas Maliakal MD Vijay Patel MD 安光惠译 李士通校 《麻醉与镇痛》2012,(3):23-28
背景一般采用短效与长效局麻药混合使用来达到神经阻滞起效快维持时间长的效果。但是,有关混合使用局麻药优点的数据报道并不多见。我们假设使用甲哌卡因与布比卡因的混合液进行区域阻滞比单纯使用布比卡因起效更快,且比单纯使用甲哌卡因时效更长。方法研究对象为64例行肩关节镜的患者(18-65岁,ASAⅠ-Ⅱ级),采用超声引导下肌间沟臂丛神经阻滞。受试者随机分配接受3种麻醉药物方案中的1种:1.5%甲哌卡因30ml、0.5%布比卡因30ml、1.5%甲哌卡因15ml与0.5%布比卡因15ml混合液。记录运动和感觉被阻滞的起效时间和维持时间。结果3组腋神经分布区(上干)的感觉阻滞的起效时间相同[甲哌卡因组(8.7±4.3)分钟、布比卡因组(10.0±5.1)分钟、混合液组(11.3±5.3)分钟,组间P=0.21]。运动神经阻滞的持续时间混合液组[(11.5±4.7)小时]位于布比卡因组[(16.4±9.4)小时]和甲哌卡因组[(6.0±4.2)小时]之间。镇痛维持时效最短的是甲哌卡因[(4.9±2.4)小时],最长的是布比卡因组[(14.0±6.2)小时],中间组是混合液组[(10.3±4.9)小时](甲哌卡因组与混合液组相比,P〈0.001,布比卡因组与混合液组相比,P=0.01)。结论超声引导下肌间沟臂丛神经阻滞时,使用1.5%甲哌卡因与0.5%布比卡因混合液的起效时间与单独使用其中任何一种药物相近,平均阻滞时间明显比单独使用甲哌卡因长,但比布比卡因短。 相似文献
19.
目的 比较罗哌卡因混合碳酸利多卡因与等效浓度罗哌卡因用于逆行锁骨下臂丛神经阻滞的效果.方法 择期行上肢手术患者60例,ASA分级Ⅰ或Ⅱ级,年龄18~64岁,体重49~ 98 kg,均在超声引导下行逆行锁骨下臂丛神经阻滞.采用随机数字表法,将患者随机分为2组(n=30),A组应用0.35%罗哌卡因30ml,B组应用0.233%罗哌卡因和0.346%碳酸利多卡因混合液30 ml.于麻醉给药后每隔5 min记录臂丛神经各分支的阻滞效果(感觉阻滞效果评估采用针刺法,运动阻滞效果评估采用Bromage分级),记录感觉和运动阻滞起效时间、麻醉给药后30 min时感觉与运动阻滞有效情况和并发症的发生情况.结果 两组臂丛神经各分支的感觉和运动阻滞起效时间及阻滞有效率比较差异无统计学意义(P>0.05).两组均未见严重并发症发生.结论 罗哌卡因混合碳酸利多卡因与等效浓度罗哌卡因行逆行锁骨下臂丛神经阻滞效果相似,提示碳酸利多卡因不能增强罗哌卡因的臂丛神经阻滞效应. 相似文献