罗哌卡因与布比卡因用于腰麻的临床比较  

Comparison of Ropivacaine and Bupivacaine Used in Lumbar Anesthesia

作　　者：朱中良[1] 史宏伟[1] 

机构地区：[1]南京医科大学附属南京第一医院麻醉科,南京210006

出　　处：《药学与临床研究》2010年第2期176-178,共3页Pharmaceutical and Clinical Research

摘　　要：目的:探讨罗哌卡因用于腰麻的特性与安全性及最佳剂量。方法:随机选择有腰麻指证的手术患者90例,双盲法将病人分成3组,每组30例,各组分别行腰麻并注入布比卡因10mg(A组)、罗哌卡因10mg(B组)、罗哌卡因15mg(C组),注药后观察各组感觉与运动神经阻滞的程度及时效,监测血压、心率,并观察呼吸状况,术后随访恶心、呕吐、头痛等并发症的发生情况。结果:A组用药后血压、心率下降明显,B、C组变化较小,A、C组感觉与运动阻滞起效时间较B组快,A组呼吸抑制、恶心呕吐发生率高于B、C组。结论:罗哌卡因与布比卡因一样可安全地用于腰麻,其最佳剂量可为15mg,这不仅能接近于布比卡因10mg的麻醉效能,同时又能减少其并发症的产生。Objective： To explore the characteristics, safety and optimal dose of ropivacaine used in lumbar anesthesia. Method： Ninety surgical patients indicating lumbar anesthesia were randomly selected and divided into 3 groups, namely 30 patients each group, by a double-blind technique. Each group received lumbar anesthesia by injection of 10mg of bupivacaine（group A）, 10mg of ropivacaine（group B） or 15mg of ropivacaine （group C）, respectively. After the injection, the degrees and time limitations of sensory nerve and motor nerve blocks were observed, the blood pressure and heart rate monitored and the respiration observed. After the surgery, the occurrences of complications such as nausea, vomiting and headache were followed up. Results： The blood pressure and heart rate were significantly reduced in group A, while there were little changes in group B and C; the times of onset of sensory and motor nerve blocks in group A and C were shorter than those in group B; the incidences of respiratory depression, nausea and vomiting of group A were higher than those of group B and group C. Conlusions： Ropivacaine can be used for lumbar anesthesia safely, and the optimal dose is 15mg with efficacy similar to 10mg of bupivaeaine and complications well controlled.

关 键 词：罗哌卡因 布比卡因 腰麻 安全性 剂量 

分 类 号：R963.3[医药卫生—微生物与生化药学]