不同剂量罗哌卡因腰硬联合麻醉用于阴式子宫切除术的临床观察  

The clinical observational research on the effectiveness of different dosages of ropivocaine injected in CSEA during transvirginal hysterectomy

作　　者：华丽[1] 王雄[1] 陈勇[1] 王两忠[1] 

机构地区：[1]成都铁路中心医院麻醉科,四川成都610081

出　　处：《四川医学》2008年第9期1177-1178,共2页Sichuan Medical Journal

摘　　要：目的观察不同剂量罗哌卡因腰硬联合麻醉(CSEA)用于阴式子宫切除术的麻醉效果,并探讨最佳剂量。方法择期行阴式子宫切除术的患者60例,随机分成3组,每组20例:A组罗哌卡因12mg,B组罗哌卡因15mg,C组罗哌卡因18mg。对3组在感觉及运动阻滞起效时间,阻滞维持时间,麻醉效果及不良反应等方面进行观察。结果A,B,C 3组都能提供良好的麻醉;3组患者的感觉阻滞起效时间,最高感觉阻滞平面,麻醉效果差异无统计学意义(P>0.05);运动阻滞起效时间C组比A组短(P<0.01);最大Bromage评分,C组>B组>A组(P<0.01);C组不良反应最多。结论罗哌卡因腰硬联合麻醉应用于阴式子宫切除术可获得满意的临床效果,其临床应用最佳剂量为15mg。Objective To evatuatc the perfect dose of ropivocaine used to combined spinal and eqidual anesthesia （ CESA） in transvaginal hysterectomy. Methods Sixty patients were divided into three groups randomly, 20 cases each group. The drug solution with ropivocaine 12mg was given in subarachnoid space in group A. The drug solation with ropivocaine 15mg was gien in subarachnoid space in group B.And the drug solation with Ropivocaine 18mg was given in subarachnoid space in group C. Motor and sensory nerves blockade, incidence of hypotension and bradycardia was evaluated and adverse effects were recorded. Results The anesthesia was satisfied in three groups;There was no significant difference in sensory block including onset time and maximum cephalad spread level among three groups（ P 〉 0.05） ;The onset time and duration of motor blockage in group C were shorter than those in group A（ P 〈 0.01） ;The maximum Bromages score, duration of anesthesia in group B were more than those in group A, but less than those in group C （ P 〈 0.01 ）, there was the most adverse effect in group C. Conclusion The satisfactory clinical effectiveness can be obtained by injecting ropivocaine in CSEA during transvirginal hydsterectomy with the best clinical dosage of 15mg.

关 键 词：罗哌卡因 腰硬联合麻醉 最佳剂量 阴式子宫切除 

分 类 号：R614.42[医药卫生—麻醉学]