罗哌因与布比卡因用于蛛网膜下腔阻滞的比较  

Comparison of ropivacaine and bupivacaine for subarachnoid block anesthesia

作　　者：高莹华[1] 陈立[1] 

机构地区：[1]海南医学院附属医院麻醉科,海南海口570102

出　　处：《海南医学院学报》2009年第9期1081-1083,共3页Journal of Hainan Medical University

基　　金：海南医学院科研基金资助学报项目(0020090147)~~

摘　　要：目的:比较0.75%罗哌卡因与0.75%布比卡因在腰麻-硬膜外联合麻醉用于下腹部手术的可行性和有效性。方法:择期行下腹部手术及下肢手术患者40例。20～60岁,ASA1～2级。随机分成两组:Rop组局麻药为0.75%罗哌卡因2mL(15mg)+无菌注射用水1mL;Bup组局麻药为0.75%布比卡因2mL(15mg)+无菌注射用水1mL,配成等比重溶液。于L3～4椎间隙穿刺,注入3mL局麻药。术中麻醉效果不佳时经硬膜外腔导管补充2%利多卡因维持麻醉效果。观察两组在感觉阻滞、运动阻滞、恢复时间上的异同,并观察围术期的不良反应。结果:两组最高阻滞平面及时间相似(P>0.05),Rop组感觉及运动阻滞起效慢且维持时间较Bup组短(P<0.05),下肢运动阻滞程度Rop组显著低于Bup组(P<0.01),运动恢复时间Rop组短于Bup组(P<0.05)。术中主要的不良反应为低血压,临床对症处理效果佳。结论:0.75%罗哌卡因用于腰麻-硬膜外联合麻醉是安全、有效的,术后运动恢复快。Objective： To compare the effects of 0.75% ropivacaine and 0.75% bupivacaine on combined spinal-epidural anesthesia for inferior abdominal surgery. Methods： Forty patients aged 20 - 60 years with ASA 1 - 2 undergoing abdominal and lower limb selective surgery were divided randomly into group A and B, patients in group A underwent anesthesia using 0.75% ropivacaine 2 mL （ 15mg） ＋ sterile water for injection 1 mL; patients in group B underwent anesthesia using 0.75% bupivacaine 2 mL （ 15 mg） ＋ sterile water for injection 1 mL, and the drugs were prepared into equal specific gravity solution. Local anesthetics 3 mL were injected through puncture between L3-4 intervertebral space. In unsatisfactory anesthesia, 2% lidocaine was added by epidural catheter for the maintenance of anesthetic effect, sensory block, motor block, recovery time and perioperative adverse reactions were observed. Results： The differences of maximum block plane and time were similar with no significance （ P 〉 0.05 ）, onset time of sensory and motor block in group A was slower and shorter than group B （ P 〈 0.05 ） , the motor block degree of lower limb motor recovery time in group A was significant lower （ P 〈0. 01 ） and storter（ P 〈0.05 ） than that of group B ; major intraoperative adverse reactions were low blood pressure, and which was solved through symptomatic treatment. Conclusion： 0.75% ropivacaine for spinal-epidural anesthesia is safe, effective, and rapid in recovery of motor function.

关 键 词：罗哌卡因 布比卡因 麻醉 

分 类 号：R614.4[医药卫生—麻醉学]