作　　者： ; ; ;

机构地区： 惠州市中医医院

出　　处： 《中国医药科学》 2019年第10期119-121,133,共4页

摘　　要： 目的探讨咪达唑仑复合左旋布比卡因用于臂丛神经阻滞上肢手术中效果。方法选择2017年4月~2018年9月行上肢手术的患者100例进行观察,采用随机数字表法均分为观察组和对照组各50例。两组患者均行超声引导下臂丛神经阻滞,对照组接受0.375%的左旋布比卡因30mL+1mL生理盐水,观察组接受0.375%的左旋布比卡因30mL+咪达唑仑50μg/kg。比较两组患者臂丛神经阻滞效果,切皮时及术毕时的VAS评分和Ramsay评分,以及围术期不良反应。结果观察组的痛觉和运动阻滞起效时间明显短于对照组,而持续时间长于对照组,且镇痛时间长于对照组,观察组切皮和术毕时的VAS评分均低于对照组,术毕时Ramsay评分高于对照组,上述差异均有统计学意义(P <0.05);两组不良反应发生率比较,差异无统计学意义(χ~2=0.102,P=0.749)。结论咪达唑仑复合左旋布比卡因用于臂丛神经阻滞上肢手术中可有效增强麻醉效果,缩短阻滞起效时间,延长持续时间及镇痛时间,安全有效。 Objective To explore the curative effects of midazolam combined with levobupivacaine in upper extremity surgery of brachial plexus block. Methods 100 patients undergoing upper extremity surgery from April2017 to September 2018 were selected and observed.According to the random number table method,they were divided into the observation group and the control group.Patients in two groups all underwent ultrasound guided brachial plexus block.The control group was given 0.375% levobupivacaine of 30 mL and normal saline of 1 mL while the observation group was given 0.375% levobupivacaine of 30 mL and midazolam of 50μg/kg.The brachial plexus block effect,VAS score and Ramsay score at the time of incision and the end of surgery and perioperative adverse reactions of patients were compared between two groups. Results The onset time of pain and motor block in the observation group was significantly shorter than that of the control group,duration was longer than that of the control group and the analgesic time was longer than that of the control group.The VAS scores of the observation group and the surgery were lower than those of the control group.VAS scores at the time of incision and at the end of surgery in the observation group were both lower than those in the control group while Ramsay score at the end of surgery was higher than that in the control group.The above differences were statistically significant(P < 0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(χ^2=0.102,P=0.749). Conclusion Midazolam combined with levobupivacaine in upper extremity surgery of brachial plexus block can effectively enhance the anesthetic effect,shorten the onset time of block and prolong the duration and analgesic time,which is safe and effective.

关 键 词： 咪达唑仑 左旋布比卡 臂丛神经阻滞 上肢手术 安全性

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