同等浓度左布比卡因与布比卡因用于颈丛神经阻滞的比较  

A Comparative study on cervical plexus block with levobupivacaine or bupivacaine

作　　者：邓学军[1] 刘文领[1] 吴桃云[1] 张建波[1] 

机构地区：[1]暨南大学医学院第六附属医院麻醉科,广东江门529031

出　　处：《吉林医学》2006年第3期269-270,共2页Jilin Medical Journal

摘　　要：目的:评价相同浓度左布比卡因与布比卡因用于颈丛神经阻滞的麻醉效果。方法:50例甲状腺肿物切除患者,ASAⅠ～Ⅱ级,随机分为两组,即布比卡因组(B组)和左布比卡因(LB组),每组25例,分别用0.25%布比卡因和0.25%左布比卡因行双侧颈丛阻滞,15ml/侧(深丛8ml,浅丛7ml),共30ml。记录麻醉效果及所产生的并发症,记录麻醉前(T0)、麻醉后的5min(T1)、10min(T2)、15min(T3)、30min(T4)及手术结束(T5)时的SBP、DBP、HR、RR、SpO2、MV、VT。结果:两组麻醉效果相同,产生的并发症也无显著性差异(P﹥0.05)。左布比卡因对抬头肌力的影响显著弱于布比卡因(P﹤0.05)。两组HR麻醉后均有显著升高(P﹤0.05),SBP、DBP在T1～T4时有显著升高(P﹤0.05)。在T5时与T0相比无显著性差异(P﹥0.05)。各时间点与T0比较两组RR、SpO2、MV和VT无显著性差异(P﹥0.05)。结论:0.25%左布比卡因与0.25%布比卡因用于颈丛神经阻滞均产生较好的麻醉效果,左布比卡因对运动神经阻滞较弱,更适用于颈丛神经阻滞。Objective To compare the clinical efficacy of levobupivacaine and bupivacaine used in cervical plexus block. Method 50 patients （ASA Ⅰ～Ⅱ） undergoing excision of thyrophyma were randomly divided into 2 groups： bupivacaine group（group B,n=25） and levobupivacaine group （group LB,n=25）.Patients received superficial cervical block with bupivacaine 0.25% in group B or levobupivacaine 0.25% 14ml in group LB.Deep cervical plexus block was performed with bupivacaine 0.25% in group B or levobupivacaine 0.25% 16ml in group LB.The efficacy of anesthesia and the possible complications of cervical plexus block were recorded for HR,SBP,DBP,SpO2,RR, MV and VT during operation were recorded as well. Results There was no significant difference between group B and group LB about the efficacy of anesthesia and the complications.But the motor block of cervical muslces in group LB was significantly weaker than that in group B（P〈 0.05）.HR,SBP and DBP increased significantly after cervical plexus block. SBP and DBP recovered when the operation completed. There were no significant changes in SpO2,RR, MV and VT （P〉 0.05）. There was no significant difference between group LB and group B in HR,SBP,DBP,SpO2,RR, MV and VT （P〉 0.05）. Conclusion Both levobupivacaine and bupivacaine produce a good cervical plexus block.Levobupivacaine is more suitable for cervical plexus block due to its less motor block.

关 键 词：左布比卡因 布比卡因 颈神经丛阻滞 

分 类 号：R614[医药卫生—麻醉学]