不同浓度罗哌卡因对经皮肾取石术患者的影响  

Effect of Ropivacaine in Different Concentration on the Patients During Percutaneous Nephrolithotomy

作　　者：刘文捷[1] 李玉成[1] 彭庆明[1] 李超[1] 

机构地区：[1]南华大学第一附属医院麻醉科,湖南衡阳421001

出　　处：《南华大学学报（医学版）》2010年第5期634-637,共4页Journal of Nanhua University(Medical Edition)

摘　　要：目的观察不同浓度罗哌卡因对经皮肾穿刺取石术(PCN-L)患者的影响。方法 120例ASA I～II择期行PCN-L手术患者,按手术顺序随机分为4组即以罗哌卡因浓度不同分为0.5%罗哌卡因组、0.33%罗哌卡因组、0.25%罗哌卡因组及0.20%罗哌卡因组,记录患者硬膜外穿刺前(T1)、给药后10 min(T2)及改变体位后5 min(T3)、15 min(T4)、60 min(T5)、120 min(T6)的平均动脉压(MAP)、心率(HR)、视觉模拟评分(VAS评分)、改良Bromage评分及罗哌卡因和其他药物用量、不良反应。结果 0.5%组患者术中MAP、HR波动较其他3组大,改良Bromage评分显著偏高,恶心呕吐的发生率最高(P<0.05);0.2%组患者则VAS评分显著高于其他3组(P<0.05);0.33%组、0.25%组在组间比较中,除0.33%组在T5时点时改良Bromage评分高于0.25%组外(P<0.05),两组其他各时点的各项比较差异均无显著性(P>0.05)。结论硬膜外使用0.33%及0.25%的罗哌卡因在镇痛完善的情况下能更好地减少PCN-L患者术中血流动力学波动、减轻运动阻滞程度,降低术中恶心呕吐等不良反应的发生率。Objective To observe the effect of ropivacaine in different concentration on the patients during percutaneous nephrolithotomy. Methods One hundred and twenty ASA I～II patients scheduled for percutaneous nephrolithotomy were randomly divided into 4 groups,named 0.5%group,0.33% group,0.25% group and 0.20% group according to the different concentration,and MAP,HR,VAS,Bromage scores,the dosage of ropivacaine and the other drugs and adverse effects were recorded at following time points：before epidural puncture（T1）,after the administration（T2） and 5min（T3）,15min（T4）,60min（T5）,120min（T6） after changing posture.Results The fluctuations of MAP and HR in 0.5%group were observably great compared with other groups,and their Bromage scores,adverse effects were significantly higher than others,too（P0.05）;VAS were much higher in 0.2%group than those in other groups.There were not significantly difference between 0.33% group and 0.25% group. Conclusions 0.33% or 0.25% ropivacaine could reduce the hemodynamic changes and motor block lever,decrease the adverse effects of the patients during percutaneous nephrolithotomy.

关 键 词：罗哌卡因 药物浓度 经皮肾穿刺取石术 

分 类 号：R614.3[医药卫生—麻醉学]