摘要
目的观察不同配伍臂丛阻滞术后的镇痛效果。方法选择ASAⅠ～Ⅱ级在臂丛阻滞下择期行上肢肘关节以上及锁骨手术患者48例,随机分成4组:M组(吗啡组n=12):吗啡1 mg+0.25%布比卡因。Q组(曲马朵组n=12):曲马朵50 mg+0.25%布比卡因。X组(新斯的明组n=12):新斯的明0.1 mg+0.25%布比卡因。D组(对照组n=12):0.25%布比卡因。均行肌间沟法臂丛神经阻滞,记录术后疼痛出现时间,并用VAS评分评价镇痛效果,同时记录药物副作用。结果M组、Q组、X组与D组的术后镇痛时间依次为(10.5±3.6)h、(11.7±4.5) h、(21.5±5.6)h与(7.6±1.9)h。与D组比较,其他3组的臂丛阻滞术后持续镇痛时间明显延长,差异有统计学意义(P<0.01)。尤以新斯的明组最为明显,且未见明显副作用。结论吗啡、曲马朵、新斯的明与布比卡因配伍用于臂丛阻滞术后镇痛均有效,尤以新斯的明持续时间最长。
Objective To investigate the postoperative analgesic effect after upper limbs and clavicle operations under braehial plexus block with different prescription. Methods Forty-eight patients（ASA Ⅰ or Ⅱ ）scheduled for upper limbs（above elbow joint and clavicle）surgery under braehial plexus block were randomly divided into four groups： Group M （n= 12） with morphine ling and 0.25% bupivacaine;Group Q（n= 12） with tramadol 50mg and 0.25% bupivacaine ,Group X （n= 12） with neostigmine 0. 1mg and 0.25% bupivaeaine ,group D（n=12） with 0.25% bupivacaine. Brachial blocks（interscalene approach）was received in all patients. The postoperative pain relief time and side effects were recorded, VAS was used to evaluate analgesic efficacy . Results The duration of postoperative analgesic in Group M,Group Q,Group X and Group D was （10.5 ± 3.6）h, （11.7 ±4.5）h,（21.5±5.6）h and （7.6±1.9）h respectively. Compared with group D ,the analgesic duration of the postoperative brachial plexus blocks was obviously prolonged in other groups （P〈0.01）particulary in Group X. The duration of postoperative analgesia in neostigmine group was the longest,in which there was no side effects to be found. Conclusion Morphine, tramadol or neostigmine with bupivacaine are all effective in postoperative analgesia, the duration of the analgesic time of group X is the longest.
出处
《实用疼痛学杂志》
2008年第5期354-356,共3页
Pain Clinic Journal
关键词
配伍
臂丛阻滞
术后镇痛
Compatibility
Brachial Plexus Block
Postoperative Analgesia
