不同浓度罗哌卡因在高胸段硬膜外麻醉的比较观察  

Observation on the Effects of Ropivacaine with Different Ooncentrations in HTEA

作　　者：彭丽云[1] 叶益汉[1] 杨少玲[1] 

机构地区：[1]茂名市人民医院麻醉科,广东茂名525000

出　　处：《国际医药卫生导报》2007年第5期54-56,共3页International Medicine and Health Guidance News

摘　　要：目的 探讨不同浓度罗哌卡因用于高胸段硬膜外麻醉的镇痛效果及其安全性，并与1％利多卡因＋0．15％地卡因合剂对照比较。方法 60例拟行乳腺手术的女性病人，随机分为A组：0．5％罗哌卡因＋0．67％利多卡因；B组：0．75％罗哌卡因＋0．5％利多卡因；C组：1％利多卡因＋0．15％地卡因。记录监测指标：SP、DP、MAPHR、ECG、SPO2，麻醉阻滞平面、麻醉起效时间，VAS评分和镇痛评定，麻醉期间不良反应。结果 最高感觉、温觉组织平面：A、B组比C组高1～2节段，无显著性差异；血液动力学比较：ABC组血压都下降10％～25％，组间比较无显著性差异；不良反应：A组呼吸困难明显少于B、C组，有显著性差异（P〈0．05）。结论 0．5％罗哌卡因用于高胸段硬膜外阻滞麻醉效果更好、更安全，值得推广应用。Objective To probe into the analgesia effect and safety of Ropivacaine with different concentrations in the high thoracic epidural anesthesia （HTEA）, then comparing it with the mixture of 1% Lidocaine plus 0.15% dicaine. Method A total of 60 cases female patients who planned to make mammary gland operation was divided into Group A （0. 5% Ropivacaine plus 0.67% Lidocaine）, Group B （0.75% Ropivacaine plus 0.5% Lidocaine） and Group C （1% Lidocaine plus 0.15% Dicaine）. The indexes needed to be recorded are as follows： SP, DP, MAP HR, ECG, SPO2 anesthesia blocking surface, anesthesia start time, VAS marking, analgesia evaluation and adverse reactions during anesthesia. Result The highest sensory and temperature-sensitive tissue surfaces have 142 sections higher in Group A and B than in Group C and without obvious differences. For the hemo dynamics, the blood pressure had dropped 10-25% respectively in Group A, B and C and without obvious differences among the groups. For the adverse reactions, the dyspnea in Group A was absolutely less than that in Group B and C and the differences were obvious （P〈0.05）. Conclusion The 0.5% Ropivacaine will have better effect and safer when it is used in HTEA, which is valuable for popularization.

关 键 词：罗哌卡因 高胸段硬膜外阻滞 乳腺手术 

分 类 号：R614[医药卫生—麻醉学]