罗哌卡因联合利多卡因在青光眼手术麻醉中的应用  

Application of Ropivacaine combined with Lidocaine for Anesthesia in Glaucoma Surgery

作　　者：杨影[1] 程依琏[1] 罗谦[1] 

机构地区：[1]四川省医学科学院.四川省人民医院眼科,四川成都610072

出　　处：《四川医学》2015年第1期57-59,共3页Sichuan Medical Journal

摘　　要：目的探讨罗哌卡因联合利多卡因与利多卡因与布比卡因混合液在青光眼手术麻醉中的应用。方法选择72例行青光眼手术的患者,随机分成2组:罗哌卡因联合利多卡因组(罗哌利多组)37例,利多卡因联合布比卡因混合组(利多布比组)35例,由同一位手术医师对手术患者施行麻醉。在注射麻醉药后的5min、10min、15min评估患者感觉和运动阻滞情况,同时监测患者的心电图、Sp O2、血压、心率,术后1h、3h、6h评估运动阻滞程度,术后1h、3h、6h、24h评定患者的疼痛情况,同时统计两组出现一过性黑蒙的发生率。结果 72例青光眼患者中,罗哌利多组(37例)有2例患者出现心率、血压、Sp O2及心电图明显改变,而利多布比组(35例)有7例术中心率、血压有明显升高,Sp O2、心电图波动较明显。利多布比组的感觉和运动阻滞起效时间分别为(2±1)min和(7±2)min;罗哌利多组感觉阻滞起效时间为(3±1)min,只有3例患者有运动阻滞,而其余34例患者没有明显的运动阻滞。感觉阻滞两组相比差异无统计学意义(P>0.05),运动阻滞两组相比差异有统计学意义(P<0.01)。术后不同时间无疼痛患者例数罗哌利多组全部优于利多布比组,两组比较差异均有统计学意义(为P<0.01)。球周注射后出现一过性黑蒙的例数罗哌利多组0例,利多布比组2例(6%),两组间差异有统计学意义(P<0.01)。结论罗哌卡因联合利多卡因在青光眼手术麻醉中应用是安全、有效、患者更舒适的麻醉方法。Objective To investigate and compare the application of ropivacaine combined with lidocaine and lidocaine combined with bupivacaine mixture in glaucoma surgery. Methods A total of 72 cases, who were taking glaucoma surgery, were randomly divided into two groups, ropivacaine combined with lidocaine group（ ropiva-lidocaine group） for 37 cases and lidocaine combined with bupivacaine group（ lido-bupivacaine group） for 35 cases. All patients were taken anesthesia by the same doctor. Sensation and motor block situation were evaluated in patients of both two groups after anesthesia for 5 minutes, 10 minutes and15minutes. Motor block degrees were evaluated at postoperative 1hour,3hours and 6hours, and Pain conditions of patients were evaluated at postoperative 1hour,3hours,6hours and 24hours. The ECG、SpO 2、blood pressure、rhythm of the heart、the occurrence of transient visual loss were observed in patients. Results The ECG、SpO 2、blood pressure、rhythm of the heart were changed for 2 cases in ropiva-lidocaine group, for 7 cases in lido-bupivacaine group . Sensation block and motor block was achieved at（2 ± 1） minutes and（7 ± 2） minutes in lido-bupivacaine group,Sensation block was achieved at（3 ± 1）minutes,motor block was achieved for 3 cases in ropiva-lidocaine group. There was not significant difference in Sensation block between two groups（P〉0. 05）,There was significant difference in motor block between two groups（P〈0. 01）. The cases of no-paining in different postoperative time in ropiva-lidocaine group are more than lido-bupivacaine group,There was significant difference between two groups（P〈0. 01）. The occurrence of transient visual loss is 0 case in ropiva-lidocaine group,and 2 cases in lido-bupivacaine group,There was significant difference between two groups（P〈0. 01）. Conclusion For patients, ropivacaine combined with lidocaine is a safe,effective and comfortable method for anesthesia in glaucoma surgery.

关 键 词：罗哌卡因 利多卡因 布比卡因 麻醉 青光眼手术 

分 类 号：R614[医药卫生—麻醉学]