利多卡因联合罗哌卡因给药方式对臂丛神经阻滞的影响OA

Objective To analyze the effects of mixed administration versus separate administration of lidocaine combined with ropivacaine on brachial plexus block.Methods A total of 90 patients who underwent upper-limb surgery under ultrasound-guided brachial plexus block at Zhengzhou First People's Hospital from June 2022 to July 2025 were retrospectively enrolled.According to the method of local anesthetic administration,the patients were divided into a mixed-administration group(47 cases)and a sequential fractional-injection group(43 cases).The onset times of sensory and motor block,the rates of complete sensory and motor block at 10 min and 30 min after blockade,pain scores assessed using the numeric rating scale(NRS)at 0,6,12,and 24 h after surgery,and heart rate(HR)and mean arterial pressure(MAP)at different intraoperative time points were compared between the two groups.Postoperative complications were also recorded.Results The onset times of both sensory block and motor block were shorter in the sequential fractional-injection group than in the mixed-administration group(P＜0.05).At 10 min after blockade,the rates of complete sensory and motor block were higher in the sequential fractional-injection group than in the mixed-administration group(P＜0.05),whereas no significant differences were observed between the two groups at 30 min(P＞0.05).There were no statistically significant differences between the two groups in NRS scores at any postoperative time point or in HR and MAP at different intraoperative time points(P＞0.05).The incidence of postoperative complications was low in both groups,with no significant difference between them(P＞0.05).Conclusion Compared with mixed injection,fractional injection of lidocaine combined with ropivacaine can significantly shorten the onset time of brachial plexus block and improve the early(10 min)complete block rate,but it has no significant effect on the final(30 min)complete block rate,postoperative analgesic efficacy,or intraoperative hemodynamics.