Discussion Of Dose Lidocaine Combined With Ropivacaine In The Supraclavicular Brachial Plexus Block Guided By Ultrasound

Objective:To discuss the effect of different dose lidocaine combined with ropivacaine in the supraclavicular brachial plexus guided by ultrasound.Methods:120ASA I-II patients undergoing hand or forearm operation were divided into six groups (n=15):local anesthetic was1%lidocaine combined with0.375%lopivacaine. The patients were divided into two groups of guiding by ultrasound group and anatomical landmarks group. Each group was divided in to3subgroup, each subgroup include20patients, ultrasound/manual anatomical ropivacaine0.5group, ultrasound/manual anatomical ropivacaine0.4group, ultrasound/manual anatomical ropivacaine0.3group, which the dose of lidocaine combined with ropivacaine was0.5、0.4、0.3mL/kg. The onset and intensity of sensory block of musculocutaneous, median, radial and ulnar nerves were measured and analgesia was rated as excellent, effective and failure. Result:The operation time of guiding by ultrasound group was shorter than anatomical landmarks group. The onset time of analgesia block and the excellent and good rate of ultrasound ropivacaine0.5group, ultrasound ropivacaine0.4group、 ultrasound ropivacaine0.3group are respectively better than manual anatomical ropivacaine0.5group、 manual anatomical ropivacaine0.4group、 manual anatomical ropivacaine0.3group. The onset time of analgesia block of ultrasound ropivacaine0.5group and ropivacaine0.4group、 manual anatomical ropivacaine0.5group and ropivacaine0.4group have had no statistical significance, which was faster than ultrasound ropivacaine0.3group. The good rate of ultrasound ropivacaine0.5group. ultrasound ropivacaine0.4group、 ultrasound ropivacaine0.3group、 manual anatomical ropivacaine0.5group had no statistical significance, but was better than the manual anatomical ropivacaine0.4and0.3group. The complications of ultrasound group and anatomical landmarks group had statistical significance.Conclusion:Local analgesia dose can be shorten significantly when interscalene brachial plexus block is performed under ultrasound guidance. With1%lidocaine combined with0.375%lopivacaine(0.3mL/kg), BPB guided by ultrasound provided better block, more security shorter onset time and less toxicity.