罗哌卡因复合肾上腺素高胸段硬膜外麻醉药效学和安全性  

Pharmacodynamics and safety of ropivacaine with adrenaline used for upper thoracic epidural anesthesia

作　　者：刘兰萍[1] 马民玉[1] 刘春兰[1] 马君志[1] 

机构地区：[1]郑州大学第一附属医院麻醉科,郑州450052

出　　处：《中原医刊》2006年第7期3-5,共3页Central Plains Medical Journal

基　　金：河南省科技攻关资助项目(编号:0211043900)

摘　　要：目的 探讨罗哌卡因单用或复合肾上腺素高胸段硬膜外麻醉的药效学和安全性。方法 40例ASAⅠ-Ⅱ级行乳腺肿瘤手术患者，随机分为罗哌卡因组（RP组）和罗哌卡因复合肾上腺素组（RP＋AD组），每组20例；两组患者均选择第3—4胸椎穿刺并置管，在2min内RP组注入0．5％罗哌卡因1．3mg·kg^-1，RP＋AD组注入加1：20万肾上腺素的0．5％罗哌卡因1．3mg·kg^-1。观察注药后两组感觉和运动阻滞效果，循环、呼吸的变化以及不良反应的发生情况。结果 两组感觉和运动阻滞特征相似（P〉0．05），阻滞效果均评定为优；麻醉期间循环、呼吸功能均较稳定：不良反应发生率低。结论 0．5％罗哌卡因高胸段硬膜外麻醉，镇痛效果满意，加肾上腺素对0．5％罗哌卡因的药效学没有明显影响，用于临床是安全、可行的。Objective To investigate the pharmacodynamics and safety of ropivacaine with adrenaline used for upper thoracic epidural anesthesia（UTEA）. Methods Fourty female patients （ASA Ⅰ - Ⅱ ） undergoing breast surgery were divided into two groups randomly ： group RP（ ropivacaine group, n = 20 ） and group RP ＋ AD（ ropivacaine with adrenaline group, n = 20）. UTEA was performed at the T3-4 interspace by using epidural catherter. Patients of group RP and RP ＋ AD received 0.5% ropivacaine 1.3 mg · kg^-1 and 0. 5% ropivacaine 1.3 mg · kg^-1 plus adrenaline 5μg · ml^-1 epidurally in 2 min, respectively. The efficacy of sensory and moter blockade, the changes of indexes for circulation and respiration after injection were observed. The adverse reactions were recorded during anesthesia. Results The two groups were similar with respect to epidural block characteristics （ P 〉 0.05 ）. The superior rate of anesthesia was 100%. The circulation and respiration function were relative stable. The incidence of adverse reactions were low. Conclusion The anesthesia efficacy of 0.5% ropivacaine for UTEA is satisfactory. The addition of adrenaline did not improve markedly the pharmacodynamics by 0.5% ropivacaine. This anesthesia method is safe and feasible in clinic.

关 键 词：罗哌卡因 肾上腺素 硬膜外麻醉 药效学 安全性 

分 类 号：R614[医药卫生—麻醉学]