不同浓度左旋布比卡因硬膜外麻醉药效学及安全性研究  

Pharmacodynamics and safety of levobupivacaine of different concentrations used for epidural anesthesia

作　　者：王承海[1] 马民玉[1] 冉菊红[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12期12-14,共3页Central Plains Medical Journal

摘　　要：目的探讨不同浓度左旋布比卡因腰段硬膜外麻醉的药效学特性及安全性。方法40例ASA Ⅰ-Ⅱ级择期行直肠或结肠癌手术患者，随机分为Ⅰ和Ⅱ组，每组20例。均选择L1、2硬膜外穿刺成功后。分别注入0．75％或0．5％左旋布比卡因2rag·kg^-1。观察注药后感觉和运动阻滞情况，血流动力学和心电图（ECG）变化以及麻醉期间的不良反应。结果感觉及运动阻滞起效时间Ⅰ组短于Ⅱ组（P〈0．05），感觉和运动雏持时间Ⅰ组长于Ⅱ组（P〈0．05），Ⅰ组最大运动阻滞程度评分大于Ⅱ组（P〈0．05）；注药后两组收缩压（SBP）、舒张压（DBP）和平均动脉压（MAP）逐渐降低，且20min及以后各时点值与注药前比较，差异有统计学意义（P〈0．05）；注药后两组心率（HR）的逐渐加快，20min及以后各时点与注药前比较差异有统计学意义（P〈0．05）。两组不良反应发生率均较低。结论 左旋布比卡因腰段硬膜外麻醉安全有效，0．75％左旋布比卡因麻醉效果优于0．5％左旋布比卡因。Objective To investigate the pharmacodynamics and safety of levobupivacaine of different concentrations for epidural anesthesia. Methods A total of 40 patients（ ASA Ⅰ-Ⅱ undergoing elective rectum or colon cancer surgery ） were randomly allocated into group Ⅰ and Ⅰ（20 in each group）. In both groups, the lumbar epidural anesthesia was performed at the L2、2 interspace. Patients of group Ⅰ and Ⅱ received 0.75% or 0.5% levobupivacaine（2mg/kg） epidurally in 1.5rain, respectively. Sensory and motor block after injection were assessed. The changes of hemodynamics and ECG after injection were observed. The adverse reactions were recorded during anesthesia. Results The onset time of sensory and motor block in group Ⅰwere significantly shorter than that in group Ⅱ（ P〈0.05 ）. The maintenance time of sensory and motor block in group Ⅰwere significantly longer than that in group Ⅱ （ P〈0.05 ） . The scores of maximum degree of motor block in group Ⅰ were more than that in group Ⅱ （P〈0.05 ）. After injection in both groups, the SBP, DBP and MAP deceased gradually, which was significantly different at 20min and each time point after 20min from that before injection （ P〈0.05 ）. After injection the HR increased gradually in both groups, which was significantly different at 20min and each time points after 20 min from that before injection（P〈0.05）. Few adverse reactions occurred in both groups . Conclusion Levobupivacaine for lumbar epidural anesthesia is safe and effective ,and the anesthesia efficacy of 0.75% levobupivacaine is better than that of 0.5% levobupivacaine.

关 键 词：左旋布比卡因 硬膜外麻醉 药效学 

分 类 号：R614[医药卫生—麻醉学]