Antalgic Effectiveness Of Ketorolac Combined With Local Anaesthetics For Ultrasound–guided Brachial Plexus Block

Objective:Toobservetheantalgiceffectivenessof ultrasound-guided brachial plexus block with ketorolac combined with local anaesthetics.Methods:The randomized double blind control method was used in this study.Forty forearm surgery patients from extremities trauma surgery with ASA gradeⅠorⅡcondition were randomly assigned to two groups by the random number table.All patients were treated with supraclavicular combined axillary brachial plexus block guided by ultrasound.All patients were opend peripheral veins,and were monitored for heart rate（HR）、mean arterial pressure（MAP）、pulse oxygen saturation（SpO₂）.Oxygen was inhaled with a mask.Under the guidance of ultrasound,the same 50 mm、22 G Peripheral nerve block puncture needle was used to block the superior clavicular brachial plexus and then axillary brachial plexus.In the observation group,supraclavicular brachial plexus block was performed using 0.375%ropivacaine and 1%lidocaine 20 ml combined with 30 mg ketorolac.Axillary brachial plexus block was performsd using 1%lidocaine 10 ml.In the control group,supraclavicular brachial plexus block was performed using 0.375%ropivacaine and 1%lidocaine 20 ml combined with 1 ml saline.Axillary brachial plexus block was performsd using 1%lidocaine 10 ml.We monitored and recorded the sex、the age、the height、the weigh、the duration of anesthesia operation,operation and tourniquet,the amount of bleeding、the heart rate（HR）、mean arterial pressure（MAP）、pulse oxygen saturation（SpO₂）and Ramsay sedation score at the 5 time points（T1 was five minutes before the block,T2 was when the block was complete,T3 was five minutes after the block,T4 was ten minutes after the block and T5 was thirty minutes after block.）And the duration of the sensory block,VAS of 4、8 and 12 h after brachial plexus block,complications and the satisfaction of anesthesia were also monitored and recorded.Results:There was no significant difference in sex,age,height,weight and ASA grade between the two groups（P>0.05）.There was no significant difference in duration of anesthesia operation,operation and tourniquet between the two groups（P>0.05）.And there was no difference in the amount of bleeding between the two groups（P>0.05）.At the above five time points,there was also no significant difference in the heart rate（HR）、mean arterial pressure（MAP）、pulse oxygen saturation（SpO₂）and Ramsay sedation score（P>0.05）.The duration in the observation group were longer than in the control group（P<0.05）.The VAS of 4、8 and 12 h after brachial plexus block in the observation group were lower than in the control group（P<0.05）.There were no complications in both two groups.The observation group had higher anesthetic satisfaction scores than the control group（P<0.05）.Conclusion:Ketorolac combined with lidocaine and ropivacaine for the ultrasound-guided brachial plexus block can prolong the duration of analgesia and lead to better analgesic effect and higher anesthetic satisfaction scores.