甲磺酸罗哌卡因复合氯胺酮硬膜外麻醉用于上腹部手术的临床研究  

Clinical anesthetic effects of epidural infusion with ropivacaine mesylate combined with ketamine

作　　者：刘鹏斌[1] 王平均 

机构地区：[1]西安交通大学医学院第二附属医院麻醉科,西安710004 [2]渭南市第一医院麻醉科

出　　处：《山西医科大学学报》2007年第9期836-838,共3页Journal of Shanxi Medical University

摘　　要：目的观察硬膜外甲磺酸罗哌卡因复合氯胺酮在上腹部手术的麻醉效果。方法50例ASAⅠ-Ⅱ级上腹部手术患者随机分为两组:甲磺酸罗哌卡因复合氯胺酮组(RK组,n=25)和甲磺酸罗哌卡因组(R组,n=25)。硬膜外穿刺部位均为T8-9间隙,每组硬膜外首剂量均为2%利多卡因5ml(试验量),随后加入0.894%甲磺酸罗哌卡因10ml,RK组复合氯胺酮0.3mg/kg(1ml),R组复合生理盐水1ml。评定麻醉期间的镇痛效果、运动阻滞情况,记录感觉阻滞达T6、T4及最高平面时间、镇痛持续时间和不良反应及辅助用药情况。结果RK组感觉阻滞达T6、T4及最高平面时间缩短,镇痛持续时间延长(P<0.05),镇痛效果和运动阻滞情况两组间无显著性差异(P>0.05),未见明显不良反应。结论甲磺酸罗哌卡因复合氯胺酮可以显著增强上腹部手术时甲磺酸罗哌卡因的硬膜外麻醉效果。Objective To observe the anesthesic effects of epidural infusion with ropivacaine mesylate combined with ketamine during operation on abdominal region. Methods Fifty patients （ASA Ⅰ - Ⅱ ） scheduled for the operation on abdominal region were di- vided randomly into two groups（ n = 25 in each group）. Epidural puncture and catheterization were routinely carried out and 0. 894% ropivacaine mesylate（R group） or that with 0.3 mg/kg ketamine（RK group）was used for epidural block. The onset time and duration of analgesia, the degree of motor block and side effects were recorded and compared. Results Compared with R group, the onset time of sensation block , the time reaching to T6 and T4, and those to the highest level of analgesia were shorten significantly in RT group （P〈0.05）. The duration of analgesia in RK group was longer than that in R group （P〈0.05）. There was no significant difference in the potency of analgesia, the degree of motor block and side effects （ P 〉 0. 05）. Conclusion The epidural ropivacaine mesylate combined with ketamine could enhance the anesthetic effects in the operation on abdominal region.

关 键 词：麻醉 硬膜外 甲磺酸罗哌卡因 氯胺酮 硬膜外阻滞 

分 类 号：R614.4[医药卫生—麻醉学]