甲磺酸罗比卡因与盐酸罗比卡因用于硬膜外阻滞的效应比较  

Comparison of the effects of lumbar epidural block with methansulfonic ropivocaine and hydrochloric ropivacaine

作　　者：李一亮[1] 彭章龙[1] 

机构地区：[1]上海第二医科大学附属瑞金医院麻醉科,200025

出　　处：《临床麻醉学杂志》2004年第10期590-592,共3页Journal of Clinical Anesthesiology

摘　　要：目的 评价甲磺酸罗比卡因用于硬膜外阻滞的效应和安全性。方法 45例择期行下腹或下肢手术病人,随机分别接受用甲磺酸罗比卡因(8.94 mg/ml,观察组)或盐酸罗比卡因(7.5mg/ml,对照组)施行的硬膜外阻滞。观察两组在感觉阻滞、运动阻滞、镇痛和肌肉松弛方面的效果,同时观察用药前后肝肾功能变化。结果 观察组和对照组感觉阻滞平面达到T6以上的病例分别为84.3％和76％(P>0.05),Bromage≥3级的病例分别90％和92％(P>0.05)。两组感觉阻滞平面固定时间、Bromage达到最大级别时间、最大级别维持时间和运动阻滞维持时间均无显著性差异(P>0.05)。两组镇痛及肌松满意率无显著性差异。观察组术中2例发生低血压,2例发生心动过缓,而对照组仅1例发生低血压。两组术后24 h天冬氨酸氨基转移酶(AST)、天冬氨酸转氨酶(ALT)、尿素氮(BUN)和肌酐(Cr)均在正常范围。结论 甲磺酸罗比卡因与盐酸罗比卡因行硬膜外阻滞的效应基本相同,且无明显毒性。Objective To compare the effects and safety of methansulfonic ropivacaine with hydrochloric ropivacaine used for lumbar epidural block. Methods Forty-five patients,undergoing selective lower abdomen or lower extremity surgery, were randomly designed to receive 0. 894% of methansulfonic ropivocaine (experiment group,n=20) or hydrochloric ropivacaine (control group,n=25) for lumbar epidural block. Sensory block,motor block,quality of analgesia and abdominal wall relaxation, and liver and renal functions were assessed. Results The percentage of sensory block to T6 level and Bromage≥3 scales were 84. 3% ,76% and 90% ,92% in experiment and control group,respectively (P>0. 05). No differences between two groups were observed in relation to the fixed time of sensory block level, the time of Bromage to maximal scale, the duration of maximal Bromage scale and of the motor block. The quality of analgesia and abdominal wall relaxation were similar in both groups. Hy-potension(n = 2) and bradycardia(n=2) occurred in 4 patients in experiment group, while hypotension in 1 patient in control group. The aspartate aminotransferase( AST) ,alanine aminotransferase( ALT) , blood urea nitrogen(BUN) and creatinine(Cr) in 24 hours postoperatively were all in the normal limits in both groups. Conlusion The effects and safety of methansulfonic ropivacaine for lumbar epidural anesthesia are similar to those of hydrochloric ropivacaine.

关 键 词：罗比卡因 硬膜外阻滞 观察 对照组 甲磺酸 运动阻滞 阻滞平面 低血压 镇痛 下肢手术 

分 类 号：R614[医药卫生—麻醉学] R714.3[医药卫生—外科学]