罗哌卡因复合舒芬太尼蛛网膜下隙阻滞在下肢骨科手术中的应用  

Effects of spinal anesthesia with ropivacaine combine sulfentanil in lower limb orthopedic surgery

作　　者：贾方[1] 徐桂茹[2] 高鲁渤[1] 

机构地区：[1]天津医科大学肿瘤医院麻醉科天津市肿瘤防治重点实验室,天津300060 [2]天津市天津医院

出　　处：《天津医科大学学报》2010年第2期279-281,共3页Journal of Tianjin Medical University

摘　　要：目的:评价小剂量舒芬太尼复合罗哌卡因行蛛网膜下隙阻滞在下肢骨科手术的麻醉效果及对患肢运动功能恢复的影响。方法:60例ASAⅠ～Ⅱ级择期行下肢骨科手术患者随机分为3组:Ⅰ组轻比重0.15%罗哌卡因6ml;Ⅱ组0.15%罗哌卡因6ml内含舒芬太尼5μg;Ⅲ组重比重0.6%罗哌卡因1.5ml。记录注药前即刻、注药后3、5、10、20、30min收缩压、舒张压、心率;感觉阻滞平面消退时间、感觉阻滞平面固定后双下肢Bromage评分、VAS评分、镇痛时间以及注药后48h内出现的不良反应。结果:Ⅱ、Ⅲ组镇痛时间显著延长。Ⅲ组患侧Bromage评分1分的为95%,显著高于Ⅰ、Ⅱ组;健侧Ⅰ、Ⅱ组Bromage评分3分者均为100%,明显高于Ⅲ组。Ⅲ组血流动力学指标5、10、20min点与Ⅰ、Ⅱ组相比较差异有统计学意义。结论:罗哌卡因复合舒芬太尼用于下肢骨科手术麻醉效果满意,镇痛时间延长,对患侧肢体运动神经阻滞弱,有利于骨科手术患者术后早期主动进行功能锻炼,促进术后康复。Objective： To evaluate the effects of subarachnoid low doses sulfentanil combined with ropivacaine on lower limb orthopedic surgery and the recovery of the wounded limbs＇ motor functions. Methods： Sixty ASA I -II patients undergoing lower limb orthopedic surgery were randomly divided into three groups （n=20 each）：Group I received hypobaric 0.15%ropivacaine 6 ml;Group II received the same 0.15% ropivacaine 6 ml but contain sulfentanil 5 ug; Group III received Re-weighting 0.6% ropivacaine 1.5 ml.SBP, DBP and HR were measured just before subarachnoid injection and 3,5,10,20, 30 min after subarachnoid injection; the duration of sensory block, the Bromage score after sensory block fix,VAS score,the duration of analgesia and the relative complications during 48 h after operation were recorded. Results： The duration of analgesia in group II and III were longer . There were 95% of the wounded limbs in group m that Bromage scores were 1, which was higher significantly than in group I and II ; There were 100% of unwounded limbs that Bromage scores was 3 in group I and II, which was higher significantly than in group m .There were significant differences in hemodynamics at the point of 5,10 and 20 min in group III compared with group I and II. Conclusion： The effect of low doses of subarachnoid sulfentanil combined with ropivacaine on lower limb orthopedic surgery are satisfaction.With extended the duration of analgesia, slight effect to the wounded limbs which is contributed to the patients to do functional exercises early and promote rehabilitation.

关 键 词：罗哌卡因 舒芬太尼 蛛网膜下隙阻滞 下肢骨科手术 

分 类 号：R614[医药卫生—麻醉学]