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[1%甲哌卡因与腋路阻滞:感觉和运动阻滞的持续时间]

[1% mepivacaine and axillary block: duration of the sensory and motor blockade].

作者信息

Choquet O

机构信息

Département d'anesthésie-réanimation, hôpital de la Conception, CHU de Marseille, France.

出版信息

Ann Fr Anesth Reanim. 1998;17(9):1104-8. doi: 10.1016/s0750-7658(00)80003-9.

Abstract

OBJECTIVES

To assess the duration of both sensory and motor blockade of brachial plexus with 40 mL 1% mepivacaine after axillary or midhumeral approach.

STUDY DESIGN

Prospective, open, non-comparative, multicentric study.

PATIENTS

One hundred and eighty patients, ASA physical class 1 and 2, scheduled for hand or forearm surgery under brachial plexus block were included.

METHODS

A midhumeral or axillary brachial plexus block using a nerve stimulator was performed with 40 mL of 1% mepivacaine. Sensory blockade was tested for each cutaneous area (median, radial, ulnar, musculocutaneous and medial cutaneous nerve of the forearm) using pin-prick. Motor blockade was assessed by grip strength of the hand. Incidence and duration of analgesia, anaesthesia and motor blockade were assessed. The incidence of tourniquet pain and the time when pain occurred were determined.

RESULTS

According to the nerve area tested, analgesia and anaesthesia were obtained in 98% and 85% of cases respectively; duration of anaesthesia was between 150 +/- 40 to 167 +/- 49 minutes and duration of analgesia was from 184 +/- 50 to 205 +/- 51 minutes. Duration of paralysis was 144 +/- 40 minutes and duration of paresis was 190 +/- 51 minutes. Pain occurred in three out of 138 patients at tourniquet inflation and in six patients after completion of surgery.

CONCLUSIONS

Mid humeral or axillary block with 40 mL of 1% mepivacaine is highly successful and provides efficient surgical anaesthesia for various surgical procedures of intermediary duration.

摘要

目的

评估腋路或肱骨中段入路注射40毫升1%甲哌卡因后臂丛神经感觉和运动阻滞的持续时间。

研究设计

前瞻性、开放性、非对照、多中心研究。

患者

纳入180例ASA身体状况分级为1级和2级、计划行臂丛神经阻滞下手部或前臂手术的患者。

方法

使用神经刺激器行肱骨中段或腋路臂丛神经阻滞,注射40毫升1%甲哌卡因。使用针刺测试每个皮肤区域(正中神经、桡神经、尺神经、肌皮神经和前臂内侧皮神经)的感觉阻滞情况。通过手部握力评估运动阻滞情况。评估镇痛、麻醉和运动阻滞的发生率及持续时间。确定止血带疼痛的发生率及疼痛出现的时间。

结果

根据测试的神经区域,分别有98%和85%的病例获得了镇痛和麻醉效果;麻醉持续时间为150±40至167±49分钟,镇痛持续时间为184±50至205±51分钟。麻痹持续时间为144±40分钟,轻瘫持续时间为190±51分钟。138例患者中有3例在止血带充气时出现疼痛,6例在手术结束后出现疼痛。

结论

肱骨中段或腋路注射40毫升1%甲哌卡因阻滞成功率高,可为各类中等时长的手术提供有效的手术麻醉。

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