罗哌卡因用于2种椎管内麻醉方法在髓核摘除术中的效果观察  

Observation of ropivacaine used in two kinds of spinal anesthesia methods in epidural operative

作　　者：张宁平[1] 潘志强[1] 张敏[1] 

机构地区：[1]中国人民解放军第478医院,昆明市650200

出　　处：《临床合理用药杂志》2009年第23期24-26,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察0.5%罗哌卡因用于腰-硬联合阻滞和硬膜外阻滞在髓核摘除术中的临床疗效、安全性及优缺点。方法60例择期行髓核摘除术的病例随机分为腰-硬联合阻滞组(A组)和硬膜外阻滞组(B组),每组30例。观察感觉及运动神经阻滞情况、镇痛效果、生命体征变化及不良反应。结果A组感觉阻滞起效时间小于B组差异有统计学意义(P<0.01),感觉阻滞维持时间和最高阻滞平面及运动阻滞起效时间、维持时间2组差异无统计学意义(P>0.05),Bromage最高评分值A组大于B组,A组镇痛效果优于B组差异均有统计学意义(P<0.05)。2组间血压、心率、SpO2变化及不良反应无明显差异。结论罗哌卡因椎管内麻醉用于髓核腰摘除术具有良好的临床应用前景。与硬膜外阻滞相比,腰-硬联合阻滞起效快,用药量少,阻滞效果更满意。Objictive Observation of 0.5% ropivacaine for spinal-epidural block and epidural anesthesia in the discectomy in the clinical efficacy, safety and the advantages and disadvantages. Methods 60 cases of patients for elective discectomy were randomly divided into spinal-epidural anesthesia group （A group, n = 30 ）and epidural anesthesia group（ B group, n = 30）. Observed the sensory and motor nerve block, analgesic effects, changes in vital signs and adverse reactions. Results Sensory block onset time of group A was less than B group,the difference was statistically significant（P 〈0.01 ） ,the maintain time of sensory block and the maximum block plane and motor block onset time, maintenance time, had no statistical difference between these two groups （ P 〉 0.05 ） , the maximum bromage score of A group was greater than B group, the analgesic effect of A group was better than B group, the differences were statistically significant （ P 〈 0.05 ）. The blood pressure, heart rate, SpO2 changes and adverse reactions of these two groups had no significant difference. Conclusion Ropivacaine spinal anesthesia for the nucleus pulposus of lumbar discectomy had a good prospect for clinical application. Compared with epidural anesthesia, spinal-epidural block had a rapid onset,less propofol and blocking effect satisfactly.

关 键 词：罗哌卡因 腰-硬联合阻滞 硬膜外阻滞 髓核摘除术 疗效 

分 类 号：R614[医药卫生—麻醉学]