不同剂量罗哌卡因腰麻在膝关节镜手术中的临床观察  

Clinical observation on different dosages of ropivacaine in spinal anaesthesia during knee arthroscopy

作　　者：蓝晓文[1] 韩琪[1] 李荣胜[1] 谢华杰[1] 廖永强[1] 毛丽君[1] 

机构地区：[1]东莞市人民医院麻醉科,广东东莞523059

出　　处：《海南医学》2012年第16期19-20,共2页Hainan Medical Journal

摘　　要：目的比较不同剂量罗哌卡因腰麻用于膝关节镜手术的安全性和有效性。方法择期行膝关节镜手术ASAⅠ～Ⅱ级患者75例，随机分为三组（Ⅰ组、Ⅱ组、Ⅲ组）。于L3-4间隙蛛网膜下腔注入罗哌卡因2ml（分别含罗哌卡因7．5mg、10mg、15mg），观察记录感觉、运动阻滞情况和不良反应的发生情况。结果感觉阻滞起效时间为Ⅰ组〉Ⅱ组〉Ⅲ组（P〈0．05或P〈0．01），感觉阻滞最高平面、运动阻滞程度和运动阻滞维持时间均为Ⅰ组〈IⅠ组〈Ⅲ组（P〈O．05或P〈O．01），Ⅰ组患者有2例痛觉阻滞不完善而改用硬膜外药才能行手术，注药20rain后双下肢运动阻滞O级者Ⅰ组、Ⅱ组分别有5例和2例，而Ⅲ组则无。Ⅰ组和Ⅱ组分别有4例和1例出现止血带胀痛等反应。m组有2例出现低血压。结论10mg罗哌卡因腰麻可满足大部分患者膝关节镜手术需要，但仍应根据手术时间长短、患者性别和身高等酌情增减剂量。Objective To evaluate the safety and cfficacy ofdiffcrent dosages ofropivacaine in spinal anaes- thesia during knee arthroscopic surgcry. Methods Scven-five patients （ASA physical smms Ⅰ -Ⅱ） scheduled to knee ahroscopy were randomly divided into three groups （group Ⅰ -Ⅱ and Ⅲ）, which reccive 7.5 rag, 10 mg and 15 mg ropivacaine injected intrathecally at the Lintcrvcrtebral space, respectively. The solutions were prepared to a total volumc of 2 ml. Results The onsct time of sensory block and motor block was significantly longer in group Ⅰ than group Ⅱ and group Ⅲ （P〈0.05 or P〈0.01）. The highest level of sensory block was significantly higher, the poten- cies of motor block was significantly severe, and ambulation time was significantly longer in patients received larger dosages ofropivacaine. Two patients in group Ⅰ received epidural injection before surgery because of inadequate an- aesthesia. Five and two patients in group Ⅰ and group Ⅱ had no motor block 20 minutes after injected intrathecally. Two patients in group Ⅲ reveived ephedrine because of hypotension. Conclusion Subarachnoid block with 10 mg ropivacaine can be used in most patients during knee arthroscopy. But the dosage of ropivacaine must be changed to be suitable for surgery duration, the gender and stature of the patient.

关 键 词：罗哌卡因 麻醉 蛛网膜下腔 膝 关节镜手术 

分 类 号：R614[医药卫生—麻醉学]