The Application Of Different Concentration Ropivacaine In The Nerve Block Of Axillary Brachial Plexus

IntroductionIn recent years, stimulator of peripheral nerve extensive application, anaesthesia of nerve block gradually recognized. But because of the toxicity of the local anesthetic, especially long effect of local anesthetic bupivacaine as the representation with strong toxicity,so application are restrict in clinic. For the weak toxicity of ropivacaine, it presence solve the problem to some extent. Use the bupivacaine as the control, observe the security and the block effect of three different concentrations of ropivacaine through the nerve block of axillary brachial plexus, discuss the suitable concentration in the apply of ropivacaine to anaesthetizing.MethodChoose 40 ASA grade Ⅰ - Ⅱ dergee, age 18-50 years, the weight 45 -90 Kgs, sufferers with forearm surgical selective operation. Random, double -blind to divided them into 4 groups (10/group). the nerve block of the axillary brachial plexus uses the medicine is ( Ⅰ group) 0. 5% Ropivacaine40ml; ( Ⅱ group) 0. 33% Ropivacaine 40ml; ( Ⅲgroup) 0. 2% Ropivacaine40ml; (Ⅳ group) 0. 25% Bupivacaine 40ml, respectively. After anaesthetize records the feeling,motor block initial effected time ,feeling,motor block duration,observe negative reaction ( chill, examination, eclampsia or tic et) and satisfaction degree of nerve block. Assay the blood sugger value and content of plasma Cortisol before and after operation 45 mins. record the BP, HR, SpO2andECG value ofbasal and after the anaesthesia lOmins, 20mins, 30mins after entering into the teatre. Statistics the processing: various index signs and data with mean ± standard deviation(x ±s). Applied SPSS11.0 statistical software to do statistical processing. Use couple - T - test to compare different hour point in the measurement data group,use T -text of two independent samples between two groups,use Chi - squared test to compare enumeration data. P <0.05have obvious differences.ResultAll cases did not find excrescent and negative reaction of ECG. A felling of block intitial effect time of Ⅰ - Ⅳ groups are 5.22 ± 1.89,7.02 ± 1.98,12.72±2.95,5.32 ± 1.75mins respectively,motor block intitial effect time are 6. 86±2. 03,9. 01 ± 2. 25,15. 36 ± 3. 97,7. 18 ± 1. 02mins respectively, feeling block duration are 1057.80 ± 187.59,508.80 ± 111. 81,180.60 ±35.60,1134. 00 ± 194.34mins respectively,motor block duration are 892. 80 ± 154.11,430. 20 ±96.91,141. 60 ±31. 14,958. 80 ± 159. 97mins respectively. The above -mentioned each value group Ⅰ and group Ⅳ did not have obvious differences (p>0.05) , group Ⅱ and group Ⅳ have obvious differences (p <0. 05) , group Ⅲ and group Ⅳ have obvious differences ( p < 0. 01). Satisfactions of nerve block comparision between each group, group Ⅰ ,group Ⅱ and groupⅣ did not have obvious differences (p >0.05) , group Ⅲ shows lower than groupⅣ obviously (p< 0.01). the blood sugger value and content of plasma Cortisol at 45mins of operation of group Ⅲ is higher than before operation (p <0.01) ,no obvious differences in other three groups (p >0. 05). there are no obvious differences on the BP, HRand SpO2 value of basal and after the anaesthesia 10mins, 20mins, 30mins after entering into the teatre inside the groups or between two groups.DiscussionRopivacaine is a kind of Amide type local anesthetic synthesis in 1957, which was firstly on sale in Holland in 1996, and is widespread used in American and European clinic,We China introduced it in 1999 and applied in clinic. For...