甲磺酸罗哌卡因、左旋布比卡因与布比卡因低位硬膜外麻醉90例效能比较  

Comparison the effect of Ropivacaine Mesylate,Bupivacaine,Levobupivacaine to low epidural anesthesia

作　　者：李友安[1] 马群莹[2] 田佳[3] 方园[1] 陈光娥 王润丽 陶静[1] 单东海 

机构地区：[1]陕西省安康市人民医院麻醉科,安康725000 [2]陕西省安康市人民医院骨科 [3]云南省昆明市第一人民医院麻醉科

出　　处：《陕西医学杂志》2009年第9期1207-1209,共3页Shaanxi Medical Journal

摘　　要：目的:评价国产的3种不同长效酰胺类局麻药在低位硬膜外麻醉中的临床效能和不良反应。方法:择期下肢手术病人90例,ASAI～II级,年龄20～65岁,体重42～65kg,随机分成3组(n=30):0.5%甲磺酸罗哌卡因组(A组)、0.5%左旋布比卡因组(B组)和0.5%布比卡因(C组)。行连续低位硬膜外麻醉,观察感觉阻滞起效时间、感觉阻滞平面上界、运动阻滞起效时间、运动阻滞程度及麻醉质量。结果:A组运动阻滞起效时间,最大运动阻滞时间明显长于C组(P<0.05),与B组相比无显著性差异(P>0.05),A组最大Bromage评分为0级、I级的例数和与B、C组相比有显著性差异(P<0.05),B组的运动阻滞持续时间明显短于A、C组(P<0.05)。3组患者均未发生局麻药相关不良反应。结论:0.5%甲磺酸的罗哌卡因、0.5%左旋布比卡因和0.5%布比卡因低位连续硬膜外麻醉能满足下肢手术的要求,均有良好的感觉和运动阻滞效果,3种药物麻醉效能相似。Objective： To evaluate the efficacy of three different types of long-acting amide local anesthetics in epidural anesthesia in effect and adverse reactions. Methods： Low continuous epidural anesthesia was observed. Group A was injected 0. 5%ropivacaine mesylate while group B with 0.5 % L-bupivacaine and group C with 0. 5% bupivacaine. Motor the onset time of sensory block, sensory block levels on the sector, block onset time, block level and quality of anesthesia. Results ： The block onset time, maximal exercise block of time of group A was longer than that in group C significantly （P 〈0. 05）,It was not significantly different with group B （P〉0.05）. It was significantly different on the largest Bromage score of 0 points, 1 point and the number of cases between group A and group B and C （P〈0.05）, The duration of motor block of group Bwas significantly shorter than that in group A and C （P〈0. 05）. Adverse reactions of local anesthetics did not occur. Conclusion：The 0.5% mesylate ropivacaine, 0.5% levobupivacaine and 0.5% bupivacaine for epidural anesthesia all can meet the requirements of lower limb surgery, have a good effect of sensory and motor block, the effect of three drugs is similar to anesthesia.

关 键 词：麻醉 硬膜外 甲磺酸盐类/治疗应用 布比卡因/治疗应用 对比研究 

分 类 号：R927.2[医药卫生—药学] R614.42