天津医药 ›› 2020, Vol. 48 ›› Issue (10): 997-1000.doi: 10.11958/20200507

• 药物临床观察 • 上一篇    下一篇

2.5 mg和5 mg地塞米松对罗哌卡因臂丛阻滞效果的影响

胡光俊,李莉,宋晓阳,黎笔熙,甘国胜   

  1. 解放军中部战区总医院麻醉科(邮编430070)
  • 收稿日期:2020-03-17 修回日期:2020-06-22 出版日期:2020-10-15 发布日期:2020-10-30
  • 通讯作者: 胡光俊 E-mail:jeanhu@163.com
  • 基金资助:
    湖北省卫计委面上资助项目(WJ2018H0082)

Effects of 2.5 mg and 5 mg dexamethasone on ropivacaine brachial plexus nerve block

HU Guang-jun, LI Li, SONG Xiao-yang, LI Bi-xi, GAN Guo-sheng   

  1. Department of Anesthesiology, General Hospital of the Central Theater Command of the Chinese PLA, Wuhan 430070, China
  • Received:2020-03-17 Revised:2020-06-22 Published:2020-10-15 Online:2020-10-30
  • Contact: Guang-Jun HU E-mail:jeanhu@163.com

摘要:

摘要:目的 比较罗哌卡因复合2.5 mg或5 mg地塞米松对超声引导下锁骨上入路臂丛阻滞的效果。方法 2018年5月—2019年7月在中部战区总医院行肱骨下段手术治疗患者90例,随机数法分成D2.5、D5及C组,每组30例。所有患者均在超声引导下行锁骨上入路臂丛阻滞,D2.5、D5、C组分别给予罗哌卡因150 mg复合地塞米松2.5 mg、5 mg、生理盐水。记录患者感觉、运动阻滞起效时间及术后第1次需要镇痛药物时间(感觉阻滞时间)和运动阻滞时间。同时记录患者术后48 h内帕瑞昔布钠和盐酸羟考酮的使用剂量及术后12、24、48 h静止和活动下疼痛数字评分(NRS)。结果 3组间感觉、运动阻滞起效时间差异无统计学意义。D2.5、D5组术后第1次需要镇痛药物时间、运动阻滞时间显著长于C组(均P<0.01)。术后48 h内D2.5组帕瑞昔布钠和D5组盐酸羟考酮的剂量低于C组(均P<0.05)。术后12 h,D2.5、D5组静止和活动下NRS显著低于C组(均P<0.01);D2.5、D5组术后血糖值高于C组(均P<0.01),D2.5、D5组术后血糖值高于术前(均P<0.01)。结论 2.5 mg和5 mg地塞米松等效能延长罗哌卡因经锁骨上入路臂丛阻滞时间和患者术后第1次需要镇痛药物时间。

关键词: 神经传导阻滞, 臂丛, 地塞米松, 罗哌卡因

Abstract:

Abstract: Objective To evaluate effects of 2.5 mg and 5 mg of dexamethasone combined with ropivacaine for ultrasound-guided brachial plexus nerve block. Methods A total of 90 patients undergoing humerus surgery were enrolled in this study from May 2018 to July 2019, and patients were randomly divided into three groups, namely group D2.5, D5 and C , respectively. Patients received ultrasound-guided supraclavicular nerve block with dexamethasone 2.5 mg (group D2.5), 5 mg (group D5) or just saline combined with 150 mg ropivacaine (group C). The onset time of sensory and motor block and the time of the first analgesic administration after surgery (sensory block time) and the duration of motor block were recorded. Dosages of parecoxib sodium and oxycodone hydrochloride prescribed 48 hours after surgery together with rest and dynamic numeric rating scale (NRS) at 12, 24 and 48 hours after surgery were recorded. Results There were no significant differences in the onset time of sensory and motor block between the three groups. In group D2.5 and group D5, the time of first analgesic administration and the duration of motor block were significantly longer than those of group C (all P<0.01). The dosages of parecoxib sodium in group D2.5 and oxycodone hydrochloride in group D5 within 48 hours after surgery were lower than those of group C (all P<0.05). At 12 h after surgery, the rest and dynamic NRS were significantly lower in the group D2.5 and group D5 than those in the group C (P<0.01). Postoperative blood glucose levels were significantly higher in group D2.5 and group D5 than those of group C (all P<0.01). The blood glucose levels after operation were significantly higher than those before operation in group D2.5 and group D5 (P<0.01). Conclusion Dexamethasone 2.5 mg or 5 mg are equivalent in enhancing brachial plexus block of single-shot supraclavicular brachial plexus block with ropivacaine and the time of the first analgesic administration after surgery.

Key words: nerve block, brachial plexus, dexamethasone, ropivacaine