中国药物警戒 ›› 2012, Vol. 9 ›› Issue (12): 710-712.

• 基础及临床研究 • 上一篇    下一篇

舒芬太尼与地塞米松对罗哌卡因神经阻滞作用影响的比较研究

张大志1, 刘永盛2, 周海滨1, 王怀江1*   

  1. 1北京积水潭医院麻醉科,北京 100035；
    2 广州仁爱集团仁爱医院麻醉科,广东 广州 510175
  • 收稿日期:2012-09-25 出版日期:2012-12-10 发布日期:2015-08-07
  • 通讯作者: 王怀江,男,学士,副主任医师,临床麻醉术后镇痛。E-mail:zhangdazhi23@yahoo.com.cn
  • 作者简介:张大志,男,硕士,主治医师,临床麻醉术后镇痛

Effects of Sufentanil and Sexamethasone on Nerve Blocking Effect of Ropivacaine

ZHANG Da-zhi1, LIU Yong-sheng2, ZHOU Hai-bin1, WANG Huai-jiang1*   

  1. 1 Department of anesthesiology, Beijing Ji Shuitan hospital, Beijing 100035, China;
    2 Department of Anesthesiology, Renai Hospital of Guangzhou Renai Corporation, Guangdong Guangzhou 5010175, China
  • Received:2012-09-25 Online:2012-12-10 Published:2015-08-07

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摘要： 目的比较舒芬太尼、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90例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,按随机分组、双盲给药,I组（对照组）：1%罗哌卡因20mL加入生理盐水30mL,II组：1%罗哌卡因20mL加入舒芬太尼20 g（2mL）、生理盐水28mL,III组：1%罗哌卡因20mL加入地塞米松10mg（2mL）、生理盐水28mL;观察各项指标。结果I组患者腰丛感觉阻滞持续时间和运动阻滞持续时间分别为7.9±3.6 h和5.9±3.4h,坐骨神经阻滞持续时间分别为8.2±3.5h和6. 6±3.2h,明显短于II组（腰丛分别为15.1±2.4h和10.2±3.5h,坐骨神经分别为16.3±2.7h和11.7±3.8h）和III组（腰丛分别为23.6±4.2h和14.7±5.6h,坐骨神经分别为23.3±2.4h和14.1±5.1h）（P <0.01）。II组患者感觉阻滞持续时间和运动阻滞持续时间明显短于III组（P <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明显高于II、III组（P <0.05）。结论0.4 g ·mL-1的舒芬太尼和0.2mg ·mL-1地塞米松均能明显延长0.4%罗哌卡因腰丛-坐骨神经阻滞作用时间,但地塞米松较舒芬太尼延长罗哌卡因作用时间要长。

关键词: 罗哌卡因, 舒芬太尼, 地塞米松, 神经阻滞

Abstract: ObjectiveTo compare effects of sufentanil and dexamethasone on the action of ropivacaine. Methods90 patients were randomly allocated into three groups with 30 cases each in a double-blinded method. Guided by a nerve stimulator, lumbar plexus combined sciatic nerve block was performed with 1%ropivacaine 20mL plus normal saline(NS) 30ml in group I,1%ropivacaine 20mL plus sufentanil 20 g(2mL) and normal saline(NS) 28mL in group II, or 1%ropivacaine 20mL plus dexamethasone 10mg and normal saline(NS) 28mL in group III, so as to observe the each target. ResultsThe durations of sensory and motor blockade in group I were lumbar plexus(7.9±3.6, 5.9±3.4)h and sciatic nerve(8.2±3.5,6.6±3.2)h, respectively ,which were significantly shorter than(15.1±2.4, 10.2±3.5)h and(16.3±2.7, 11.7±3.8)h in group II and(23.6±4.2, 14.7±5.6)h and(23.3±2.4, 14.1±5.1)h in group III(P <0.01). The durations of sensory and motor blockade in group II were significantly shorter than group III(P <0.01). The postoperative sufentanil consumption and PCA button press times in group I were more than that of group II and group III(P <0.05) at 48h after operation. ConclusionSufentanil 0.4 g ·mL-1 and 0.2mg ·mL-1 dexamethasone significantly prolonged the action of ropivacaine in lumbar plexus combined sciatic nerve block and dexamethasone prolonged the action of ropivacaine more than that of sufentanil.

Key words: ropivacaine, sufentanil, dexamethasone, nerve block