{"title":"罗哌卡因和布比卡因对超声引导下锁骨上臂丛神经阻滞肘下手术患者的起效、阻滞持续时间和血流动力学参数变化的麻醉效果。","authors":"Bishwo Ram Amatya, Mallika Rayamajhi, Puja Thapa, Aashish Shah, Thaneshwar Rijal, Anjan Khadka, Shova Shrestha","doi":"10.33314/jnhrc.v21i02.4653","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Supraclavicular brachial plexus block is commonly used regional anesthetic technique for below elbow upper limb surgeries. Ultrasound and nerve stimulator are used for higher success rates and fewer complications. Ropivacaine has been used as an alternative to Bupivacaine for rapid onset and longer duration along with lesser or no cardiac and neurotoxicity.The study was conducted with objective of assessing sensory and motor block characteristics of Bupivacaine and Ropivacaine in terms of onset, duration and adverse effects.</p><p><strong>Methods: </strong>A prospective observational study lasting three month duration from 15th February, 2022 to 14th May, 2022 was conducted among 60 patients divided by convenient sampling method into 30 in Group R (0.2% Ropivacaine 30 ml) and 30 in Group B (0.2% Bupivacaine 30 ml) undergoing below elbow orthopedic surgery under ultrasound and peripheral nerve stimulator guided supraclavicular brachial plexus block.</p><p><strong>Results: </strong>Block using Ropivacaine as compared to Bupivacaine had faster sensory onset in minutes (7±3.37 vs. 10.17±3.34; P value 0.0005), faster motor onset in minutes (10.17±5 vs. 22.33±5.04), shorter duration of sensory block in minutes (437.16±55.54 vs. 633.38±58.33), shorter duration of motor block in minutes (411±57.15 vs. 698.16±47.89), shorter time required for rescue analgesia in minutes (78.66±25.56 vs. 73.83±21.11) and no complications.</p><p><strong>Conclusions: </strong>0.2% Ropivacaine can be used as an alternative to 0.2% Bupivacaine in below elbow upper limb orthopaedic surgeries under ultrasound and nerve stimulator guided supraclavicular brachial plexus block for rapid onset of sensory block and early regression of motor block.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Anaesthetic Effects of Ropivacaine and Bupivacaine on Onset, Duration of Block and Changes in Hemodynamic Parameters in Patients Undergoing Below Elbow Surgeries Under Ultrasound Guided Supraclavicular Brachial Plexus Block.\",\"authors\":\"Bishwo Ram Amatya, Mallika Rayamajhi, Puja Thapa, Aashish Shah, Thaneshwar Rijal, Anjan Khadka, Shova Shrestha\",\"doi\":\"10.33314/jnhrc.v21i02.4653\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Supraclavicular brachial plexus block is commonly used regional anesthetic technique for below elbow upper limb surgeries. Ultrasound and nerve stimulator are used for higher success rates and fewer complications. Ropivacaine has been used as an alternative to Bupivacaine for rapid onset and longer duration along with lesser or no cardiac and neurotoxicity.The study was conducted with objective of assessing sensory and motor block characteristics of Bupivacaine and Ropivacaine in terms of onset, duration and adverse effects.</p><p><strong>Methods: </strong>A prospective observational study lasting three month duration from 15th February, 2022 to 14th May, 2022 was conducted among 60 patients divided by convenient sampling method into 30 in Group R (0.2% Ropivacaine 30 ml) and 30 in Group B (0.2% Bupivacaine 30 ml) undergoing below elbow orthopedic surgery under ultrasound and peripheral nerve stimulator guided supraclavicular brachial plexus block.</p><p><strong>Results: </strong>Block using Ropivacaine as compared to Bupivacaine had faster sensory onset in minutes (7±3.37 vs. 10.17±3.34; P value 0.0005), faster motor onset in minutes (10.17±5 vs. 22.33±5.04), shorter duration of sensory block in minutes (437.16±55.54 vs. 633.38±58.33), shorter duration of motor block in minutes (411±57.15 vs. 698.16±47.89), shorter time required for rescue analgesia in minutes (78.66±25.56 vs. 73.83±21.11) and no complications.</p><p><strong>Conclusions: </strong>0.2% Ropivacaine can be used as an alternative to 0.2% Bupivacaine in below elbow upper limb orthopaedic surgeries under ultrasound and nerve stimulator guided supraclavicular brachial plexus block for rapid onset of sensory block and early regression of motor block.</p>\",\"PeriodicalId\":16380,\"journal\":{\"name\":\"Journal of Nepal Health Research Council\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-12-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Nepal Health Research Council\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.33314/jnhrc.v21i02.4653\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nepal Health Research Council","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.33314/jnhrc.v21i02.4653","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
背景:锁骨上臂丛阻滞是肘部以下上肢手术常用的区域麻醉技术。使用超声波和神经刺激器的成功率更高,并发症更少。本研究旨在评估布比卡因和罗哌卡因在起效、持续时间和不良反应方面的感觉和运动阻滞特性:方法:2022年2月15日至2022年5月14日,对60名接受肘部以下骨科手术的患者进行了为期三个月的前瞻性观察研究,研究采用方便抽样法,将其分为R组(0.2%罗哌卡因30毫升)30人和B组(0.2%布比卡因30毫升)30人,在超声和外周神经刺激器引导下进行锁骨上臂丛阻滞:结果:与布比卡因相比,使用罗哌卡因的阻滞具有更快的感觉起始时间(7±3.37 vs. 10.17±3.34;P值0.0005)、更快的运动起始时间(10.17±5 vs. 22.33±5.04)、更短的感觉阻滞持续时间(437.16±55.54 vs. 633.38±58.33),运动阻滞时间更短(411±57.15 vs. 698.16±47.89),抢救镇痛所需时间更短(78.66±25.56 vs. 73.83±21.11),无并发症:结论:在超声和神经刺激器引导下的锁骨上臂丛阻滞中,0.2% 罗哌卡因可作为 0.2% 布比卡因的替代品用于肘部以下上肢矫形手术,可快速产生感觉阻滞,并尽早消除运动阻滞。
Anaesthetic Effects of Ropivacaine and Bupivacaine on Onset, Duration of Block and Changes in Hemodynamic Parameters in Patients Undergoing Below Elbow Surgeries Under Ultrasound Guided Supraclavicular Brachial Plexus Block.
Background: Supraclavicular brachial plexus block is commonly used regional anesthetic technique for below elbow upper limb surgeries. Ultrasound and nerve stimulator are used for higher success rates and fewer complications. Ropivacaine has been used as an alternative to Bupivacaine for rapid onset and longer duration along with lesser or no cardiac and neurotoxicity.The study was conducted with objective of assessing sensory and motor block characteristics of Bupivacaine and Ropivacaine in terms of onset, duration and adverse effects.
Methods: A prospective observational study lasting three month duration from 15th February, 2022 to 14th May, 2022 was conducted among 60 patients divided by convenient sampling method into 30 in Group R (0.2% Ropivacaine 30 ml) and 30 in Group B (0.2% Bupivacaine 30 ml) undergoing below elbow orthopedic surgery under ultrasound and peripheral nerve stimulator guided supraclavicular brachial plexus block.
Results: Block using Ropivacaine as compared to Bupivacaine had faster sensory onset in minutes (7±3.37 vs. 10.17±3.34; P value 0.0005), faster motor onset in minutes (10.17±5 vs. 22.33±5.04), shorter duration of sensory block in minutes (437.16±55.54 vs. 633.38±58.33), shorter duration of motor block in minutes (411±57.15 vs. 698.16±47.89), shorter time required for rescue analgesia in minutes (78.66±25.56 vs. 73.83±21.11) and no complications.
Conclusions: 0.2% Ropivacaine can be used as an alternative to 0.2% Bupivacaine in below elbow upper limb orthopaedic surgeries under ultrasound and nerve stimulator guided supraclavicular brachial plexus block for rapid onset of sensory block and early regression of motor block.
期刊介绍:
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