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在罗哌卡因中添加曲马多和氯胺酮会延长腋路臂丛神经阻滞的时间吗?

Does the addition of tramadol and ketamine to ropivacaine prolong the axillary brachial plexus block?

作者信息

Senel Ahmet Can, Ukinc Ozlem, Timurkaynak Alper

机构信息

Department of Anesthesiology, Medical Faculty of Karadeniz Technical University, 61080 Trabzon, Turkey.

Department of Orthopedics, Medical Faculty of Karadeniz Technical University, 61080 Trabzon, Turkey.

出版信息

Biomed Res Int. 2014;2014:686287. doi: 10.1155/2014/686287. Epub 2014 May 6.

Abstract

BACKGROUND AND OBJECTIVES

A prospective, randomized, controlled, double-blind clinical trial to assess the effect of tramadol and ketamine, 50 mg, added to ropivacaine in brachial plexus anesthesia.

METHODS

Thirty-six ASA physical statuses I and II patients, between 18 and 60 years of age, scheduled for forearm and hand surgery under axillary brachial plexus block, were allocated to 3 groups. Group R received 0.375% ropivacaine in 40 mL, group RT received 0.375% ropivacaine in 40 mL with 50 mg tramadol, and group RK received 0.375% ropivacaine in 40 mL with 50 mg ketamine for axillary brachial plexus block. The onset times and the duration of sensory and motor blocks, duration of analgesia, hemodynamic parameters, and adverse events (nausea, vomiting, and feeling uncomfortable) were recorded.

RESULTS

The onset time of sensorial block was the fastest in ropivacaine + tramadol group. Duration of sensorial and motor block was the shortest in the ropivacaine + tramadol group. Duration of analgesia was significantly longer in ropivacaine + tramadol group.

CONCLUSION

We conclude that when added to brachial plexus analgesia at a dose of 50 mg, tramadol extends the onset and duration time of the block and improves the quality of postoperative analgesia without any side effects.

摘要

背景与目的

一项前瞻性、随机、对照、双盲临床试验,旨在评估在臂丛神经麻醉中,将曲马多和50毫克氯胺酮添加到罗哌卡因中的效果。

方法

36例年龄在18至60岁之间、ASA身体状况为I级和II级、计划在腋路臂丛神经阻滞下进行前臂和手部手术的患者被分为3组。R组接受40毫升0.375%的罗哌卡因,RT组接受40毫升含50毫克曲马多的0.375%罗哌卡因,RK组接受40毫升含50毫克氯胺酮的0.375%罗哌卡因用于腋路臂丛神经阻滞。记录感觉和运动阻滞的起效时间、持续时间、镇痛持续时间、血流动力学参数以及不良事件(恶心、呕吐和不适感)。

结果

罗哌卡因+曲马多组感觉阻滞的起效时间最快。罗哌卡因+曲马多组感觉和运动阻滞的持续时间最短。罗哌卡因+曲马多组的镇痛持续时间明显更长。

结论

我们得出结论,当以50毫克的剂量添加到臂丛神经镇痛中时,曲马多可延长阻滞的起效和持续时间,并改善术后镇痛质量,且无任何副作用。

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