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1、不同剂量地塞米松对罗哌卡因神经阻滞作用的影张大志'王东信2王怀江'【摘要】目的比较不同剂最地塞米松复合罗哌卡因神经阻滞对罗哌卡因阻滞时效的影响。方法60例患者随机分为I、11、III三组,每组20例。所有患者均在神经刺激器定位下行坐骨神经复合腰丛阻滞麻醉。I组:1%罗哌卡因20ml加入生理盐水30ml;II组:1%罗哌卡因20ml加入地塞米松5mg、生理盐水29ml;III组:1%罗哌曰大
2、20ml加入地塞米松10mg>生理盐水28ml0结果T组患者感觉阻滞持续时间和运动阻滞持续时间[腰从(7.8+4.2,5.7±3.l)h、坐骨神经(&3±3.
3、6,6.5±3.8)h]明显短于II组[腰丛(16.3+6.5,10.9±4.2)h、坐骨神经(17.3±5.2,11.2±3.5)h]和III组[腰丛(24.2±5.8,14.6±5.1)h、坐骨神经(24.7±4.4,13.6±4.8)h](A0.01),11组患者感觉阻滞持续吋间和运动阻滞持续时间明显短于III组(/<0.01)。I组患者48h舒芬太尼的消耗量、按压总次数和有效次数比TT.TTT组高(/K0.05)。结论5mg和10mg地塞米松均能延长0.4%罗哌卡因腰从-坐骨神经阻滞作用时间,1Omg地塞米松较5mg地塞米松延长罗哌卡因作
4、用时间长。【关键词】罗哌卡因,地塞米松,神经阻滞Effectofdifferentdosesdexamethasoneonactionofropivacainej21ZhangDazhi/WangDongxinWangHuaijiangz1Departmentofanesthesiology,BeijingJiShuitanhospital,Beijing100035,China2Departmentofanesthesiology,ThefirsthospitalofPekingUniversity,Beijing100034,China[Ab
5、stract]objectiveTocompareeffectofdifferentdosesdexamethasoneontheactionofropivacaine.MethodsSixtypatientswererandomlyallocatedintothreegroupswith20caseseach・Guidedbyanervestimulator,lumbarplexuscombinedsciaticnerveblockwasperformedwithl%ropivacaine20mlplusnormalsaline(NS)30ml
6、ingroupI,l%ropivacaine20mlplusdexamethasone5mgandnormalsaline(NS)29mlingroupII,orl%ropivacaine20mlplusdexamethasonelOmgandnormalsaline(NS)28mlingroupIII.ResultsThedurationsofsensoryandmotorblockadeingroupIwere[lumbarplexus(7.8±4・2,5.7±3.1)handsciaticnerve(8.3±3.6,6・5±3・8)hJ,r
7、espectively,whichweresignificantlyshorterthan[(16.3±6.5,10.9+4.2)hand(17.3+5.2,11.2+3.5)hJingroupIIand[(24.2+5.8,14.6+5」)hand(24.7+4.4,13.6+4.8)h]ingroupIII(P<0.01).ThepostoperativesufentanilconsumptionandPCAbuttonpresstimesingroupIweremorethanthatofgroupIIandgroupIII(P<0.05)
8、at48hafteropcration.ConclusionDexamethasone5mgand1OmgsignificantlyprolongedtheactionofropivacaineinlumbarplexuscombinedsciaticnerveblockanddexamethasonelOmgprolongedtheactionofropivacainemorethanthatofdexamethasone5mg.【Keywords]ropivacaine,dexamethasone,nerveblock卜•肢骨科术后疼病往往被
9、患者描述为难以忍受特别是手术后的而二天是最痛的时期叫作者单位:1100035北京帀,北京积水潭医院麻醉科2100034北京市,北人医院麻