左旋布比卡因与罗哌卡因局部浸润麻醉对开颅手术术中血液动力学及血糖的影响  

Effects of 0.25%Levobupivacaine and 0.5%Ropivacaine on haemodynamics and blood glucose level in craniotomy

作　　者：黄再青[1] 齐小冰[1] 王俊飞[2] 郭卫东[1] 

机构地区：[1]内蒙古医学院第三附属医院麻醉科,内蒙古包头014010 [2]内蒙古医学院第三附属医院医务科,内蒙古包头014010

出　　处：《中国现代医学杂志》2012年第9期88-90,共3页China Journal of Modern Medicine

摘　　要：目的探讨在全麻开颅手术中用0.25%左旋布比卡因和0.5%罗哌卡因手术切口局部浸润麻醉对血液动力学和血糖的影响。方法采用随机、双盲、对照设计,将60例接受开颅手术患者分为3组:对照组(n=20):切口浸润生理盐水;Rop组(n=20):切口浸润0.5%罗哌卡因;Lev组(n=20):切口浸润0.25%左旋布比卡因。麻醉诱导依次为静注咪达唑仑0.05mg/kg,芬太尼4ug/kg,丙泊酚2mg/kg,维库溴铵0.1mg/kg;术中吸入异氟醚维持麻醉。术中记录特定时点患者的平均动脉压(MAP)、心率(HR)、异氟醚吸入浓度,记录术前、切皮后10min、钻颅骨及术毕的血糖值。结果 MAP、HR在切皮即刻至术毕Rop组和Lev组均低于对照组(P<0.05);异氟醚浓度在缝合皮下和术毕时Rop组和Lev组低于对照组(P<0.05);血糖在切皮后10min、钻颅骨和术毕时Rop组和Lev组低于对照组(P<0.05)。结论 0.25%左旋布比卡因和0.5%罗哌卡因切口浸润麻醉,可以降低神经外科开颅引起的血液动力学波动,稳定糖代谢,有利于神经外科麻醉。【Objective】 To observe the effect of skull infiltration with 0.25%Levobupivacaine and 0.5%Ropivacaine on haemodynamics and blood glucose level in craniotomy.【Methods】 60 patients were divided to control group,Levobupivacaine group and Ropivacaine group randomly.placebo group received a skull infiltration consisting of normal saline while the Levobupivacaine group received a skull infiltration with 0.25%Levobupivacaine and the Ropivacaine group received a skull infiltration with 0.5%Ropivacaine.All patients were induced with midazolam 0.05mg/kg,fentanyl 4ug/kg,propfol 2mg/kg,vecuronium 0.1mg/kg.Intraoperative anesthesia was maintained with isoflurane.MAP,HR,FET-iso and blood glucose level at certain time point during the operation were recorded.【Results】 Compared with control group,MAP,HR,Blood glucose level was significant lower in Levobupivacaine group and Ropivacaine group at certain time points（P〈0.05）.【Conclusion】 Skull infiltration with 0.25%Levobupivacaine and 0.5%Ropivacaine can reduce fluctuation in haemodynamics craniotomy,stabilize glycometabolism,and benefit anesthesia for neurosurgery.

关 键 词：左旋布比卡因 罗哌卡因 浸润麻醉 血液动力学 血糖 

分 类 号：R614.4[医药卫生—麻醉学]