| Objective:To explore whether warming ropivacaine can reduce limb discomfort associated with phantom limb syndrome after brachial plexus block.Method:Approved by the Ethics Committee of the Affiliated Hospital of Yan ’an University,112 patients who planned to undergo upper limb operation under brachial plexus block in our hospital from December 2021 to October 2022 were selected,11 patients with malnutrition and obesity were excluded,and 1 patient who requested to withdraw from the experiment halfway was excluded.A total of 100 patients were included and randomly assigned to the normal temperature group and the warming group,50 patients in each group.The normal temperature group received ropivacaine stored at room temperature at 23～25℃,and the warming group received ropivacaine heated to37℃.Both groups received 0.4% ropivacaine 0.25ml/kg for anesthesia.The incidence of limb discomfort,PLS,duration of discomfort,degree of sensory disturbance,anesthetic effect,postoperative recovery,postoperative adverse reactions and patients’ satisfaction with anesthesia were compared between the two groups.Results : ⑴ The incidence of PLS related limb discomfort: the incidence of postoperative limb discomfort in the warming group(30%)was significantly lower than that in the normal temperature group(68%),the difference was statistically significant(P< 0.05);⑵ The incidence of PLS was not statistically significant between the two groups(P > 0.05).⑶PLS degree of sensory disturbance: there was no statistical difference in the degree of tactile disturbance between the two groups(P > 0.05),the degree of motor disturbance in the warming group was lighter than that in the normal temperature group,the difference was statistically significant(P < 0.05);(4)Discomfort duration: The duration of limb discomfort caused by sensory disorders was not statistically significant between the two groups(P > 0.05).⑸ Anesthesia effect: the onset time of sensory and motor block in the warming group was reduced by about 50% compared with the normal temperature group,and the difference was statistically significant(P < 0.05);There was no significant difference in the duration of retardation between the two groups(P > 0.05).⑹ Postoperative recovery: There were no significant differences in postoperative eating time and early functional exercise time between the two groups(P > 0.05).⑺Satisfaction evaluation: There was no statistical difference between the two groups for the satisfaction of surgeons with muscle relaxation during operation and the satisfaction of patients with postoperative overall anesthesia(P > 0.05).⑻ Adverse reaction: There was no significant difference in the incidence of nausea and vomiting within 24 h after operation between the two groups(P > 0.05).In order to further explore how warming can reduce the incidence of postoperative limb discomfort,the time difference of sensory and motor function recovery between the two groups was analyzed,and it was found that the time difference of warming group was significantly shorter than that of normal temperature group,and the difference was statistically significant(P < 0.05).And the time difference of sensory and motor function recovery was correlated with the occurrence of limb discomfort and the degree of sensory disturbance,with statistical significance(P < 0.05).Conclusion:Warming ropivacaine may reduce the degree of sensory impairment by shortening the time lag between the recovery of sensory and motor functions during anesthetic metabolism,thereby reducing the incidence of limb discomfort.In addition,it can not only meet the operation conditions,but also prevent the occurrence of postoperative limb discomfort in patients,and does not bring additional adverse reactions,which is suitable for clinical promotion. |
