Observation of the efficacy and adverse effects of Oxycodone and butorphanol as adjuvants in local anesthetics for brachial plexus block in upper limb orthopedic surgery
羟考酮与布托啡诺作为局麻药佐剂在上肢骨科手术臂丛神经阻滞的效果与不良反应观察

摘要

目的 比较羟考酮与布托啡诺作为罗哌卡因佐剂在上肢骨科手术臂丛神经阻滞中的效果及安全性。方法 90例美国麻醉医师协会（American Society of Anesthesiologists, ASA）Ⅰ-Ⅱ级上肢骨折手术患者随机分为三组：L组（单纯罗哌卡因）、Q组（羟考酮+罗哌卡因）、B组（布托啡诺+罗哌卡因）。观察痛觉消退时间、麻醉持续时间、术后疼痛评分、补救镇痛次数及炎症因子变化。结果 Q组痛觉消退时间（8.63±2.28 min）显著短于L组（12.10±3.42 min）和B组（10.43±2.91 min）（P<0.001）。Q组麻醉持续时间（586.0±137.1 min）显著长于L组（483.0±117.7 min）和B组（447.9±136.4 min）（P<0.001）。Q组术后各时间点疼痛评分均显著低于其他两组（P<0.05），补救镇痛次数最少（0.50±0.73次）。三组术前术后炎症因子[白细胞介素-6（Interleukin-6, IL-6）、C反应蛋白（C-reactive protein, CRP）、降钙素原（Procalcitonin, PCT）]变化无显著差异（P>0.05）。结论 羟考酮联合罗哌卡因作为臂丛神经阻滞佐剂，具有起效快、持续时间长、镇痛效果好、不良反应少等优势，是值得推荐的神经阻滞佐剂方案。

Abstract

Objective To compare the efficacy and safety of oxycodone and butorphanol as adjuvants to ropivacaine in brachial plexus block for upper limb orthopedic surgery.
Methods Ninety American Society of Anesthesiologists (ASA) I-II patients undergoing upper limb fracture surgery were randomly divided into three groups: L group (pure ropivacaine), Q group (oxycodone + ropivacaine), and B group (butorphanol + ropivacaine). The analgesic onset time, anesthesia duration, postoperative pain scores, rescue analgesia frequency, and inflammatory factor changes were observed.
Results The analgesic onset time in the Q group (8.63±2.28 min) was significantly shorter than that in the L group (12.10±3.42 min) and B group (10.43±2.91 min) (P<0.001). The anesthesia duration in the Q group (586.0±137.1 min) was significantly longer than that in the L group (483.0±117.7 min) and B group (447.9±136.4 min) (P<0.001). The postoperative pain scores at all time points in the Q group were significantly lower than those in the other two groups (P<0.05), with the fewest rescue analgesia administrations (0.50±0.73 times). No significant differences were observed in the changes of inflammatory factors [Interleukin-6 (IL-6), C-reactive protein (CRP), Procalcitonin (PCT)] before and after surgery among the three groups (P>0.05).
Conclusion   Oxycodone combined with ropivacaine as an adjuvant for brachial plexus block offers advantages such as rapid onset, prolonged duration, excellent analgesic effect, and fewer adverse reactions, making it a recommended adjuvant regimen for nerve block.