罗哌卡因和布比卡因在轻比重单侧腰麻中的比较  

Comparison of Hypobaric Ropivacaine and Hypobaric Bupivacaine in Unilateral Spinal Anesthesia

作　　者：刘松[1] 周胜岐[1] 赵汝有[1] 崔新亮[1] 

机构地区：[1]安徽省蚌埠医学院第二附属医院麻醉科,233040

出　　处：《中华全科医学》2010年第5期560-561,共2页Chinese Journal of General Practice

摘　　要：目的比较在骨科单侧下肢手术中罗哌卡因和布比卡因在轻比重单侧腰麻的麻醉效果。方法选择单侧下肢骨科手术60例,ASA分级Ⅰ～Ⅱ级,按照完全随机化的原则分为两组。实施单侧腰麻时,所有患者均侧卧位,患侧在上,于L3-4间隙穿刺注药。布比卡因组(B组)蛛网膜下腔注入0.375%布比卡因2ml;罗哌卡因组(R组)蛛网膜下腔注入0.375%罗哌卡因2ml;注药后两组患者均保持患侧在上侧卧位15min。记录观察两组患者注药前及注药后5,10,15和30min的心率、平均动脉压、脉搏血氧饱和度、感觉及运动阻滞的起效时间、持续时间和消退时间,并加以比较。结果R组运动阻滞起效时间较B组延长(P<0.05),运动阻滞恢复时间较B组缩短(P<0.05);其他指标两组间没有显著性差异(P>0.05)。结论罗哌卡因较布比卡因更适用于骨科下肢手术的单侧腰麻,因为罗哌卡因的运动阻滞时间较短,利于患者的早期功能锻炼和早期康复。Objective To compare the efficacy of 0.375% hypobaric ropivacaine and bupivacaine for unilateral lower limb surgery.Methods Sixty patients with ASA grade Ⅰ-Ⅱ were randomly allocated to two groups.Spinal anaesthesia was performed from the L3-4 interspace in all patients keeping the lateral decubitus position with the operative side up.Group B（n=30） received 2 ml of 0.375% hypobaric bupivacaine and group R（n=30） received 2 ml of 0.375% hyperbaric ropivacaine.Patients were kept in the lateral decubitus position for 15 minutes and were then turned to the supine position.The characteristics of spinal block,quality of spinal anaesthesia,adverse effects and recovery times were recorded.Results The onset of motor block were significantly later in group R as compared to group B（P〈0.05）.The duration of motor block were significantly shorter in group R as compared to group B（P〈0.05）.Conclusion For unilateral lower limb surgery,2 ml of 0.375% hypobaric ropivacaine is preferred to bupivacaine because it provides a faster motor recovery.

关 键 词：轻比重 腰麻 单侧 酰胺类 

分 类 号：R614[医药卫生—麻醉学] R971.2[医药卫生—外科学]