0.25%左旋布比卡因与罗哌卡因用于小儿骶管阻滞时效性的比较  

Clinical comparison between levobupivacaine and ropivacaine for caudal analgesia in children

作　　者：成忠平[1] 苑妍新 陈卫民[1] 

机构地区：[1]中国医科大学附属盛京医院麻醉科,沈阳110004 [2]大庆市龙南医院麻醉科,黑龙江大庆163453

出　　处：《实用药物与临床》2010年第1期18-19,共2页Practical Pharmacy and Clinical Remedies

摘　　要：目的研究0.25%左旋布比卡因在小儿骶管阻滞中的效果及安全性,并与0.25%罗哌卡因比较。方法选择60例(2～8岁)择期行泌尿外科手术患儿,随机分为2组:L组(0.25%左旋布比卡因)和R组(0.25%罗哌卡因),每组30例。患儿麻醉前肌肉注射阿托品0.01 mg/kg。两组经骶裂孔给予局麻药1 mL/kg。两组麻醉诱导和术中维持用七氟烷且均不行气管插管,保留自主呼吸,测定骶管阻滞的起效时间和术后镇痛情况,记录HR、MAP、SpO2,观察两组围手术期的不良反应。结果L组与R组的起效时间[(7.4±2.1)min vs(8.1±2.4)min]和镇痛时间[(423±37)min vs(388±45)min]相比,差异无统计学意义(P>0.05),未观察到局麻药的毒性反应。结论0.25%左旋布比卡因(1 mL/kg)用于小儿骶管阻滞可提供满意的麻醉效果;同浓度、同剂量的左旋布比卡因和罗哌卡因用于小儿骶管阻滞具有相似的药效学特性。Objective To investigate the analgesic efficacy and safety of 0. 25% levobupivacalne, and compare it with 0. 25 % ropivacaine for caudal anesthesia in children. Methods 60 patients（ 2 -8 years old）undergoing urogenital surgery were enrolled. Patients were randomized in a double blind manner to receive a caudal block with either 0. 25% levobupivacaine（ n = 30）or 0. 25% ropivacaine（ n = 30）to a total volume of 1 mL/kg. All patients kept respiration without intubation. All pediatrics kept respiration without intubation. Parameters were investigated including onset time and analgesia duration of caudal block and recorded adverse effects （ nausea, vomiting etc）. Results There was no significant difference between the two groups in onset times[ R group ： （ 7.4 ± 2. 1 ） rain vs L group ： （ 8. 1 ± 2.4 rain） ] and analgesia duration[ R group ： （423 ± 37 ） rain vs L group ： （ 388 ± 45 ） rain ] （ P 〉 0.05 ）. No adverse events was observed. Conclusion 0.25% levobupivacaine （lmL/kg）is well tolerated and provides effective analgesia for caudal block in children, levobupivacalne and ropivacaine have similar efficacy and safety profile with equal dosage for caudal block in children.

关 键 词：骶管阻滞 镇痛 左旋布比卡因 罗哌卡因 儿童 

分 类 号：R726.1[医药卫生—儿科]