Effects Of Different Proportions Of Ropivacaine On Phantom Limb Occurrence

Objective: To explore the effects of different proportions of ropivacaine on phantom limb occurrence,and to provide reference for further clinical research.Method: After approval by the Ethics Committee of our Hospital,104 patients who planned to receive lower limb and lower abdomen surgery under combined epidural anesthesia in the Affiliated Hospital of Yan ’an University from January 2022 to August2022 were selected and divided into two groups according to random number table method,with 52 patients in each group,respectively using ropivacaine lumbar anesthesia with different proportions of 2.5ml.Group A: 1% Ropivacaine 1.5ml+50% glucose0.1ml+cerebrospinal fluid 1.4ml;Group B: 1% ropivacaine 1.5ml+1.5ml water for injection sterilization.Two cases of epidural addition and one case of altered anesthesia were excluded during the operation.A total of 101 patients were included in the final analysis.The blood pressure and heart rate values at entry(T0),subarachnoid space 5min(T1),10min(T2),15min(T3),30min(T4)and exit(T5)of the two groups were recorded,incidence of phantom limb,type of phantom limb,duration of phantom limb,anesthetic effect,satisfaction with anesthesia,and adverse effects Reaction,etc.Result:1.The incidence of phantom limb was compared between the two groups.The incidence of phantom limb in group B was 32.0%,significantly lower than that in group A58.8%(P < 0.05).2.Both groups could be classified into phantom position and amputation illusion,depending on how the patient felt about the numb limb.Phantom position also included the sense of flexion,elongation and suspension,and the sense of absence was the amputation illusion.There was no statistical significance in different limb phantom types between the two groups(P > 0.05).3.The phantom limb duration of group A was 96.77±53.71 min and that of group B was 70.63±48.99 min,and the difference was not statistically significant(P > 0.05).4.The blood pressure and heart rate at some time points in the two groups were significantly different from the basic value of T0(P < 0.05),indicating that the changes of blood pressure and heart rate in the two groups had fluctuated over time,but the fluctuation range was no more than 10 units.The fluctuation trends of blood pressure and heart rate of the two groups were basically the same,but there was no statistical significance between the two groups(P > 0.05).5.There were no significant differences in the onset time of sensory nerve block,duration of sensory nerve block,maximum sensory nerve block plane,onset time of motor nerve block and duration of motor nerve block between the two groups(P > 0.05).The maximum motor block time in group A 10(8,13)min was significantly shorter than that in group B 18(10,27)min(P < 0.05).6.There was no statistical significance in anesthesia satisfaction between those with phantom limb and those without phantom limb in group A(P > 0.05).There was no statistical significance in anesthesia satisfaction between those with phantom limb and those without phantom limb in group B(P > 0.05).7.The incidence of adverse reactions was 12% in group A and 11.8% in group B,and there was no statistical significance between the two groups(P > 0.05).Conclusion:1.The incidence of phantom limb with light weight ropivacaine is significantly lower than that with heavy weight ropivacaine.2.There was no difference in phantom limb type and phantom limb duration between light weight ropivacaine and heavy weight ropivacaine.