盐酸罗哌卡因与盐酸布比卡因低位硬膜外阻滞的效应比较  

The comparison of the effects of lower epidural block with hydrochloric ropivacaine and hydrochloric bupivacaine

作　　者：郑自富 项燚 梅诗全 沈培[1] 李俊标[1] 崔玲[1] 

机构地区：[1]霍山县医院麻醉科,237200

出　　处：《安徽医学》2011年第3期309-311,共3页Anhui Medical Journal

摘　　要：目的比较盐酸罗哌卡因和盐酸布比卡因低位硬膜外阻滞用于子宫下段剖宫产手术的效应,为临床麻醉提供客观依据。方法 60例ASAⅠ~Ⅱ级择期子宫下段剖宫产患者,随机接受0.75%盐酸罗哌卡因（观察组）或0.75%盐酸布比卡因（对照组）硬膜外阻滞。观察两组在感觉阻滞、运动阻滞、镇痛和肌肉松弛方面的效果,同时观察手术期间心电图P-R、QRS波间期的变化及新生儿情况。结果观察组和对照组感觉阻滞平面达到T6以上的病例分别为83.3%和86.7%,Bromage≥2级的病例分别为76.7%和90%。观察组Bromage达到最大级别时间比对照组长,而观察组最大级别维持时间和运动阻滞维持时间均比对照组短,两组患者镇痛、肌松满意率及新生儿Apgar评分差异无统计学意义。两组患者术中P-R、QRS波间期均在正常范围内。结论盐酸罗哌卡因与盐酸布比卡因低位硬膜外麻醉均可产生良好的感觉和运动阻滞,两种药物药效学相似。Objective To investigate the effects of hydrochloric ropivacaine comparing with hydrochloric bupivacaine for lower epidural block on Caesarean section in order to provide basis of the clinical application.Methods 60 patients underwent selective Caesarean section,were randomly designed to receive 0.75% of hydrochloric ropivacaine（experiment group,n=30） or 0.75% hydrochloric bupivacaine（control group,n=30） for lower epidural block.Sensory block,motor block,quality of analgesia and abdominal wall relaxation,and P-R、QRS interval,and newborn were assessed.Results The percentage of sensory block to T6 level and Bromage≥2 scales were 83.3%,86.7%,and 76.7%,90% in experiment and control group,respectively.The time of Bromage to its maximal scale were longer in experiment group than that in control group（P0.05）.The duration of maximal Bromage scale and of the motor block were shorter in experiment group than that in control group（P0.05）.The quality of analgesia,abdominal wall relaxation and neonatal Apgar score were similar in both groups.In operation P-R and QRS interval were all in the normal limits in both groups.Conclusion Hydrochloric ropivacaine produces an epidural block with the similar clinical profile as hydrochloric bupivacaine does.

关 键 词：盐酸罗哌卡因 盐酸布比卡因 低位硬膜外阻滞 剖宫产 

分 类 号：R614[医药卫生—麻醉学]