Objective To explore the application efficacy of esketamine combined with ropivacaine in brachial plexus block.Methods A total of 159 patients who underwent open reduction and internal fixation for upper limb fractures were divided into three groups with 53 cases each.Group H received 0.4％ropivacaine plus esketamine 0.5 mg/kg total 40 mL,group L received 0.4％ropivacaine plus esketamine 0.1 mg/kg total 40 mL,and group C received only 0.4％ropivacaine 40 mL.The onset time and duration of sensory blockade and motor blockade were compared among the three groups.MAP and HR were recorded at the time of entering the operating room(T0),15 minutes(T1)and 30 minutes after nerve block(T2).The NRS score and SDS score at 24 hours postoperatively,the use of tramadol for analgesia and the occurrence of adverse reactions within 24 hours after operation were compared among the three groups.Results The onset time of sensory blockade in group H was shorter than that in groups of L and C(P＜0.05).The duration of sensory blockade in group H was longer than that in groups of L and C(P＜0.05),which was also longer in group L than that in group C(P＜0.05).The duration of motor blockade in groups of H and L was longer than that in group C(P＜0.05).The SDS score and NRS score at 24 hours after surgery in groups of L and H were lower than those in group C(P＜0.05).There were no statistical differences in MAP and HR among the three groups at T0-T2(P＞0.05).Within 24 hours after surgery,the proportion of tramadol used for analgesia in groups of H and L was lower than that in group C(P＜0.05).There was no statistical difference in the incidence of adverse reactions among the three groups(P＞0.05).Conclusion Combined use of esketamine and ropivacaine for brachial plexus block can prolong the duration of pain relief,improve the analgesic efficacy,reduce the use of postoperative opioid drugs,not increase adverse reactions,and decrease the incidence of postoperative depression.
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