The effect of different concentrations of local anesthetics on the ultrasound-guided supraclavicular brachial plexus block

doi:10.3877/cma.j.issn.2096-0263.2021.04.002

Abstract

Abstract:

Objective

To discuss the effect of different concentrations of local anesthetics (ropivacaine) on the ultrasound-guided supraclavicular brachial plexus block.

Methods

Eighty patients with ultrasound-guided supraclavicular brachial plexus block were selected prospectively in our hospital from January 2017 to December 2018, they were divided into the group A, group B, group C and group D according to the random number table, there were 20 cases in each group. The group A was given 1.00% ropivacaine, the group B was given 0.75% ropivacaine, the group C was given 0.50% ropivacaine, the group D was given 0.375% ropivacaine, and the four groups were injected with 10 ml ropivacaine.

Results

All patients were followed up for an average of (11.3±2.4) months. In group A, there were 12 males and 8 females, the aged was 22-72. In group B, there were 8 males and 12 females, the aged was 20-74. In group C, there were 10 males and 10 females, the aged was 23-75. In group D, there were 11 males and 9 females, the aged was 21-74. The sensory and motor block onset time of radial nerve, ulnar nerve, median nerve, musculocutaneous nerve and the anesthesia completion time in the group A, group B and group C were significantly faster than those in the group D, and the duration of anesthesia in the group A [(557.2±61.4)min], group B [(556.0±61.0)min] and group C [(553.7±60.2)min] were significantly longer than those in group D [(476.5±52.6)min] (P<0.05). The excellent and good rate of anesthesia effect in the group A, group B and group C were 100.00%, 95.00% and 95.00%, which were significantly higher than the 70.00% in the group D, the difference was statistically significant (χ²=9.614, P=0.004). The adverse reaction rate in the group A and group B were 35.00% and 30.00%, they were significantly higher than the 5.00% in the group C and the 5.00% in the group D, the difference was statistically significant (χ²=9.972, P=0.003).

Conclusions

Different concentrations of local anesthetics (ropivacaine) have different effects on ultrasound-guided supraclavicular brachial plexus block, and among them, the 0.50% ropivacaine not only has the good blocking effect, but also does not increase the adverse reactions.

Key words: Ropivacaine, Ultrasound, Clavicle, Brachial plexus, Concentrations

Zeliang Huang, Jing Bai, Cheng Wang. The effect of different concentrations of local anesthetics on the ultrasound-guided supraclavicular brachial plexus block[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2021, 07(04): 201-206.

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Figures/Tables 7

References 22

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组别	例数	性别（例，男/女）	年龄（岁，±s）	身体质量指数（kg/m²，±s）	操作时间（min，±s）	ASA（例，Ⅰ/Ⅱ）	手术类型（例，手部桡侧手术/肘部桡侧手术/上臂手术）
A组	20	12/8	40±8	23.6±2.9	4.5±0.7	8/12	6/4/10
B组	20	8/12	41±8	23.6±2.8	4.5±0.7	10/10	7/5/8
C组	20	10/10	41±8	23.5±2.8	4.5±0.8	7/13	5/6/9
D组	20	11/9	41±8	23.6±2.8	4.5±0.7	9/11	4/6/10
统计值		χ²=0.567	F=0.887	F=0.803	F=0.768	χ²=0.621	χ²=1.065
P值		0.378	0.276	0.323	0.395	0.342	0.224

组别	例数	性别（例，男/女）	年龄（岁，±s）	身体质量指数（kg/m²，±s）	操作时间（min，±s）	ASA（例，Ⅰ/Ⅱ）	手术类型（例，手部桡侧手术/肘部桡侧手术/上臂手术）
A组	20	12/8	40±8	23.6±2.9	4.5±0.7	8/12	6/4/10
B组	20	8/12	41±8	23.6±2.8	4.5±0.7	10/10	7/5/8
C组	20	10/10	41±8	23.5±2.8	4.5±0.8	7/13	5/6/9
D组	20	11/9	41±8	23.6±2.8	4.5±0.7	9/11	4/6/10
统计值		χ²=0.567	F=0.887	F=0.803	F=0.768	χ²=0.621	χ²=1.065
P值		0.378	0.276	0.323	0.395	0.342	0.224

组别	例数	桡神经	尺神经	正中神经	肌皮神经	麻醉完善	麻醉维持
A组	20	3.0±0.5^a	2.9±0.5^a	2.1±0.5^a	2.9±0.5^a	5.0±0.7^a	557.2±61.4^a
B组	20	3.1±0.5^a	2.9±0.5^a	2.1±0.5^a	3.0±0.5^a	5.1±0.7^a	556.0±61.0^a
C组	20	3.2±0.6^a	3.0±0.5^a	2.2±0.6^a	3.0±0.5^a	5.1±0.8^a	553.7±60.2^a
D组	20	3.8±0.7	3.7±0.7	3.9±0.7	3.8±0.6	6.0±0.9	476.5±52.6
F值		43.672	54.824	65.314	52.127	57.362	37.572
P值		<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数	桡神经	尺神经	正中神经	肌皮神经	麻醉完善	麻醉维持
A组	20	3.0±0.5^a	2.9±0.5^a	2.1±0.5^a	2.9±0.5^a	5.0±0.7^a	557.2±61.4^a
B组	20	3.1±0.5^a	2.9±0.5^a	2.1±0.5^a	3.0±0.5^a	5.1±0.7^a	556.0±61.0^a
C组	20	3.2±0.6^a	3.0±0.5^a	2.2±0.6^a	3.0±0.5^a	5.1±0.8^a	553.7±60.2^a
D组	20	3.8±0.7	3.7±0.7	3.9±0.7	3.8±0.6	6.0±0.9	476.5±52.6
F值		43.672	54.824	65.314	52.127	57.362	37.572
P值		<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

	桡神经	尺神经	正中神经	肌皮神经	麻醉完善	麻醉维持
A组与D组	q=4.120	q=4.408	q=9.812	q=5.078	q=3.774	q=4.472
A组与D组	P<0.001	P<0.001	P<0.001	P<0.001	P=0.001	P<0.001
B组与D组	q=3.786	q=4.136	q=9.387	q=4.682	q=3.552	q=4.418
B组与D组	P=0.001	P<0.001	P<0.001	P<0.001	P=0.001	P<0.001
C组与D组	q=3.286	q=3.846	q=8.755	q=4.311	q=3.197	q=4.325
C组与D组	P=0.002	P<0.001	P<0.001	P<0.001	P=0.003	P<0.001

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