摘要
目的:观察地塞米松对罗哌卡因臂丛阻滞效果的影响以及炎性因子水平的变化。方法:选择在臂丛阻滞下行桡骨骨折切开复位内固定术的患者60例,采用随机数字法分为生理盐水加罗哌卡因组(NR组)、地塞米松5 mg加罗哌卡因组(D5R组)和地塞米松10 mg加罗哌卡因组(D10R组),每组20例。比较三组患者感觉阻滞起效和持续时间、运动阻滞起效和持续时间、术后首次镇痛需求时间,并比较三组患者术前、术毕、术后2 h、术后4 h和术后12 h肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平的变化。结果:与NR组相比,D5R组和D10R组患者感觉阻滞持续时间和运动阻滞持续时间均延长(P<0.05,P<0.01,P<0.001),且首次镇痛需求时间均延长(P<0.05,P<0.01);与术前相比,三组患者术毕和术后各时间点的TNF-α和IL-6水平均降低(P<0.05,P<0.01,P<0.001);D5R组和D10R组患者TNF-α和IL-6水平在术毕、术后2 h、术后4 h和术后12 h均低于NR组(P<0.05,P<0.01,P<0.001)。结论:地塞米松10 mg可以延长罗哌卡因的作用时间,并能够降低炎性因子的水平。
Objective To observe the effects of dexamethasone add to ropivacaine on brachial plexus block and inflammatory cytokines. Method 60 patients with radial fractures open reduction and internal fixation under brachial plexus block were selected and randomly divided into normal saline ＋ ropivacaine group（ group NR）,dexamethasone 5 mg ＋ ropivacaine group（ group D5 R） and dexamethasone 10 mg ＋ ropivacaine group（ group D10 R）,20 cases in each group. The onset time and duration of sensory block and motor block,the time of first rescue analgesia after operation in three groups were compared,the level of Tumor necrosis factor-α（ TNF-α） and interleukin-6（ IL-6） before surgery,the end of surgery immediately,2 h、4 h and 12 h after surgery in three groups were compared. Results Compared with group NR,the duration of sensory block and motor block and the time of first rescue analgesia after operation in group D5 R and group D10 R were prolong（ P〈 0. 05,P〈 0. 01,P〈 0. 001）. Compared with before surgery and group NR,TNF-α and IL-6 were decreased at the end of surgery immediately,2 h、4 h and12 h after surgery（ P〈 0. 05,P〈 0. 01,P〈 0. 001）. Conclusion Dexamethasone 10 mg can prolong the effect of ropivacaine and reduce the level of inflammatory cytokines.
出处
《吉林医学》
CAS
2017年第10期1839-1841,共3页
Jilin Medical Journal
