罗哌卡因临床应用及神经毒性的新进展  

Latest progression of the clinical application of ropivacaine and its neurotoxicity

作　　者：张琴[1] 韩志强[2] 段志强[1] 郑渤[1] 李红霞 温海茹 ZHANG Qin;HAN Zhiqiang;DUAN Zhiqiang(Department of Anesthesiology,Bayannur Hospital,Inner Mongolia,Bayannur 015000,China;不详)

机构地区：[1]内蒙古自治区巴彦淖尔市医院麻醉科,015000 [2]内蒙古医科大学附属医院麻醉科

出　　处：《河北医药》2023年第12期1872-1877,共6页Hebei Medical Journal

基　　金：内蒙古自治区自然科学基金(编号:2013MS1139)。

摘　　要：罗哌卡因作为同布比卡因有相同作用的长时效新型酰胺类局麻药,不仅神经毒性低,作用时间长,且心脏毒性也低于布比卡因,可以呈现感觉和运动分离阻滞,且对感觉神经的阻滞大于运动神经强,感觉大于运动、仅轻度非递增性阻滞运动神经,有利于患者早期离床,恢复快,因此罗哌卡因在临床麻醉中更为实用且得到了推广。虽然罗哌卡因的神经毒性低,但是临床工作中仍有一些患者因使用了高浓度的罗哌卡因而出现一些临床上的综合征,如暂时性神经病学综合征(TNS),马尾神经综合征(CES),延迟性骶神经感觉障碍,格林-巴利综合征(GBS),需要临床工作者在应用罗哌卡因时注意降低浓度,缩短作用时间,减少用量提高其安全性和可靠性。Ropivacaine is a novel type of long-acting amide local anesthetic with the same effect as bupivacaine,which has a lower neurotoxicity and cardiac toxicity,and longer anesthetic duration than that of bupivacaine.Ropivacaine produces sensory and motor separation blocks,and the block of sensory nerve is stronger than that of motor nerve,the sensation is greater than that of motor.A mild non-incremental block of motor nerve is beneficial to the off-bed activities as early as possible and rapid recovery.Therefore,ropivacaine is more practical in clinical anesthesia that has been widely promoted.Although ropivacaine possesses a low neurotoxicity,high-dose ropivacaine causes pathological conditions like transient neurological syndrome(TNS),cauda equina syndrome(CES),delayed sacral nerve sensory impairment,and Guillain-Barrésyndrome(GBS).It is necessary to lower the concentration and dosage,and shorten the action time,thus improving the safety and reliability.

关 键 词：麻醉 局麻药 罗哌卡因 椎管内 毒性 

分 类 号：R614.4[医药卫生—麻醉学]