罗哌卡因联合碳酸利多卡因在臂丛神经阻滞麻醉中的应用

目的 研究罗哌卡因联合碳酸利多卡因在臂丛神经阻滞中的麻醉有效性和安全性。方法选择美国麻醉医师协会（ASA）Ⅰ～Ⅱ级、各类上肢手术的患者80例，随机分成两组，每组40例。A组：0．375％罗哌卡因30ml；B组：0．75％罗哌卡因15ml，联合1．73％碳酸利多卡因15ml，共30ml。按手术部位的不同，分别从肌间沟和腋路给药。观察生理指标变化、麻醉起效时间、麻醉持续时间和麻醉效果及不良反应。结果B组患者麻醉起效时间明显快于A组，差异有统计学意义（P〈0．05）。运动阻滞时间及感觉阻滞时间两组差异无统计学意义（P〉0．05）。麻醉效果B组优者达92．5％，A组麻醉优者达65．0％，A组有4例患者术中感疼痛明显需加用静脉辅镇痛助药物。两组患者均未出现局麻药中毒反应。结论罗哌卡因联合碳酸利多卡因经肌间沟及腋路臂丛神经阻滞，是一种麻醉效果优且安全的方法。

Application of ropivacaine combined lidocaine carbonate used in inter-muscular brachial plexus brachial plexus block anesthesia

Objective Study for the clinical efficacy and safety of ropivacaine combined lidocaine carbonate used in brachial plexus block anesthesia. Methods 80 patients, ASA class Ⅰ - Ⅱ, with upper limb surgery, were randomly split into ：2 groups, each group with 40 patients. Group A： received 0. 375% ropivacaine 30 ml; group B： 0.75% bupivacaine 15 ml received 1.73% lidocaine carbonate 15ml,use different drug and methods according to the surgical site. Compared each item physiological targets , the onset time, duration, anesthesia effect. Results Statistically, the anesthesia onset time of group B are shorter than groupA （ P 〈 0.05）. No significant difference in statistics between each groups on the motion blockade time and sensory blockade time（ P 〉0.05 ）. Group B anaesthesia effect satisfied with 92.5%, but group A is 65%, also four patient felt pain and need assisted with venous drug, group A and B has not patient observed local anesthetics toxic reaction. Conclusion Ropivacaine combined lidocaine carbonate used in inter - muscular brachial plexus block anesthesia is safety way with good effect.