胸段硬膜外镇痛中罗哌卡因与布比卡因对尿路功能的影响  

Effect of ropirvacaine and bubicaine on urinary tract function in thoracic epidural analgesia

作　　者：章燕 戴泽平 ZHANG Yan;DAI Ze-ping(Department of Anesthesia,The First Affiliated Hospital of Wannan Medical College,Wuhu Anhui 241000,China)

机构地区：[1]皖南医学院第一附属医院麻醉科,安徽芜湖241000

出　　处：《蚌埠医学院学报》2021年第12期1734-1736,共3页Journal of Bengbu Medical College

摘　　要：目的:通过对残余尿量以及最大尿流量的监测,比较罗哌卡因与布比卡因对胸段硬膜外镇痛(TEA)病人尿路功能的影响。方法:选取择期行开放胸腹部手术病人50例,采用随机数字表法分为A组(布比卡因镇痛组)和B组(罗哌卡因镇痛组),每组25例。分别在术前及TEA时行尿动力学检查。主要观察指标是术前与术后TEA术后残余尿量(PVR)的差异。次要观察指标是各组之间和组内最大尿流量的变化。结果:TEA期间2组PVR均较基础值增加(P<0.05),A组PVR高于B组(P<0.01);TEA期间排尿量A组大于B组(P<0.01);TEA期间2组最大尿流率和膀胱收缩指数均较基础值减少(P<0.05),且A组低于B组(P<0.01)。2组基础值和TEA期间初感尿意、强烈尿意、膀胱最大容量、膀胱顺应性参数比较差异均无统计学意义(P>0.05)。结论:罗哌卡因用于TEA的残余尿量明显低于布比卡因,罗哌卡因对逼尿肌功能的影响较小。Objective:To compare the effects of ropivacaine and bupivacaine on urinary tract function in patients with thoracic epidural analgesia(TEA)by monitoring residual urine volume and maximum urine flow.Methods:Fifty patients undergoing elective open thoracic and abdominal surgery were selected and divided into group A(bupivacaine analgesic group)and group B(ropivacaine analgesic group)by random number table method,with 25 patients in each group.Urodynamic examination was performed in preoperative and TEA.The primary observation index was the difference of postoperative residual urine volume(PVR)before and after TEA,and the secondary observation index was the change of maximum urine flow between groups and within groups.Results:During TEA,PVR in both groups increased compared with the baseline value(P<0.05),and PVR in group A was higher than that in group B(P<0.01).The urine output in group A was higher than that in group B during TEA(P<0.01).During TEA,the maximum urine flow and bladder contraction index in the two groups were decreased compared with the baseline value(P<0.05),and which in group A was lower than that in group B(P<0.01).There were no significant differences in baseline value,initial urine intention,strong urine intention,maximum bladder capacity and bladder compliance parameters between the two groups during TEA(P>0.05).Conclusions:The residual urine volume of ropivacaine for TEA is significantly lower than that of bupivacaine,which reflects that ropivacaine has little effect on detrusor function.

关 键 词：胸段硬膜外镇痛 逼尿肌功能 布比卡因 罗哌卡因 残余尿量 

分 类 号：R614[医药卫生—麻醉学]