左旋布比卡因对超声引导下肋间神经阻滞的效果比较

目的:比较等剂量不同浓度的左旋布比卡因对超声引导下肋间神经阻滞的效果。方法:择期行单侧乳房肿块切除术患者90例，随机分为3组，在超声引导下行2~5肋肋间神经阻滞麻醉，3组使用等剂量不同浓度的局麻药，分别为0.25%左旋布比卡因24 mL（A组），0.375%左旋布比卡因16 mL（B组），0.5%左旋布比卡因12 mL（C组）。观察3组患者麻醉起效时间、麻醉完善时间、手术开始切皮时疼痛视觉模拟评分、手术中牵拉深部组织时疼痛视觉模拟评分、镇痛维持时间以及麻醉镇痛不全发生率和局麻药中毒发生率。结果:3组患者麻醉起效、麻醉完善时间随左旋布比卡因浓度上升而缩短，镇痛维持时间延长（P<0.05~P<0.01）。结论:等剂量左旋布比卡因用于超声引导下肋间神经阻滞时，适当提高浓度可缩短麻醉起效时间及完善时间，延长麻醉镇痛维持时间。

Effect of levobupivacaine on intercostal nerve block guided by ultrasound

Objective:To compare the effects of different concentrations of levobupivacaine on intercostal nerve block guided by ultrasound. Methods:Ninety patients scheduled by unilateral breast tumor resection were randomly divided into three groups, and anaesthetized at 2 to 5 rib intercostal nerve block guided by ultrasound. The patients were anaesthetized with 24 mL of 0. 25%levobupivacaine(group A),16 mL of 0. 375% levobupivacaine(group B) and 12 mL of 0. 5% levobupivacaine(group C), respectively. The onset time of anesthesia,complete anesthesia time,VAS scores at the beginning of cutting skin and stretching deep tissue,duration of analgesia,and the incidences of incomplete anesthesia and local anesthetic intoxication between three groups were observed. Results:With the increasing of the concentration of levobupivacaine,the onset time of anesthesia and complete anesthesia time shortened,and the analgesia time prolonged in 3 groups(P<0. 05 to P<0. 01). Conclusions:At the same dosage of levobupivacaine, the appropriate concentration of levobupivacaine at 2 to 5 rib intercostal nerve block anesthesia guided by ultrasound can shorten the anesthesia onset time and complete time,and prolong the analgesia duration.