0.5%罗哌卡因与0.5%布比卡因等比重腰麻在老年患者髋关节手术中的应用  

APPLICATION OF 0.5% ROPIVACAINE OR 0.5% BUPIVACAINE FOR SPINAL ANESTHESIA IN ELDERLY PATIENTS SCHEDULED A HIP REPLACEMENT SURGERY

作　　者：张立涛[1] 才素芬[1] 宋海明[1] 张智勇[1] 

机构地区：[1]河北省唐山市第二医院麻醉科,063000

出　　处：《中国煤炭工业医学杂志》2013年第7期1089-1092,共4页Chinese Journal of Coal Industry Medicine

基　　金：唐山市科技攻关计划(编号:111302133a)

摘　　要：目的比较浓度均为0.5%的罗哌卡因和布比卡因等比重腰麻液在老年患者髋关节手术中的麻醉效果。方法选择77例ASAⅠ～Ⅱ级择期髋关节手术的老年患者,随机分成二组:0.5%罗哌卡因等比重腰麻组(RI)33例和0.5%布比卡因等比重腰麻组(BI)44例。观察麻醉前及麻醉后3,5,10,15,20min的血流动力学变化,并同时观察二组麻醉平面及所需时间,患肢的有效镇痛时间、有效运动阻滞时间和麻醉完全失效时间。结果①77例患者麻醉后20min麻醉平面集中在T10阶段,RI组与BI组起效时间接近,(12.3±5.9)min对(13.6±6.5)min。②当穿刺间隙、注药剂量、速度、方向都相同时,麻醉后各时间段血压下降值二组比较差异无统计学意义。③RI组麻醉后健侧肢体运动阻滞时间明显短于BI组,(98±33)min对(152±65)min,(P=0.000)。患肢开始疼痛时间和麻醉完全消失时间二组接近。结论按照实验中的麻醉方法药液浓度均为0.5%时罗哌卡因在麻醉效果、作用时间以及对血压的影响方面与布比卡因接近,但对健侧运动阻滞时间短于布比卡因。Objective To compare the anesthesia effect of 0.5%ropivacaine or 0.5% bupivacaine in spinal anesthesia in elderly patients with hip replacement.Methods Seventy-seven ASA（American Society of Anesthesiologists physical status）I～II elderly patients scheduled for hip replacement surgery under spinal anesthesia were allocated randomly into two groups：group RI（n =33）and group BI（n=44）.Group RI were received 0.5%isobaric ropivacaine,while group BI received 0.5%isobaric bupivacaine.The hemodynamic changes before anesthesia and anesthesia after 3,5,10,15,20min were recorded.The upper level of anesthesia,the onset time,analgesic time,the time of motor bloc and complete failure time of anesthesia were recorded.Results The upper level of anesthesia were controlled under T10in77 patients of anesthesia after 20 minutes,the onset time of two groups were near,12.3 ± 5.9 minutes VS 13.6 ± 6.5 min.When the position of puncture,injection dose,speed and direction were controlled samely,drop values of blood pressure after anesthesia had no significant difference between the two groups.The time of motor block of contralateral limb in groups RI were significant shorter than that in group BI,98±33 minutes VS 152±65 minutes（P=0.000）.Analgesic time and complete failure time of anesthesia were proximate in two groups.Conclusion According to the experiment method,the clinical effect of 0.5% ropivacaine for spinal anesthesia is near with 0.5% bupivacaine,but the time of motor block of ropivacaine is shorter significantly than bupivacaine.

关 键 词：罗哌卡因 布比卡因 髋关节手术 腰麻 老年人 

分 类 号：R971.2[医药卫生—药品]