摘要
目的 研究罗哌卡因用于腰麻 硬膜外联合阻滞的安全性和有效性。方法 择期行下肢或会阴部手术病人 6 0例 ,18∽ 75岁 ,ASAI～Ⅱ级 ,随机分成三组。用 1%罗哌卡因 ,0 .75 %布比卡因和 1%地卡因各 1ml,分别加入 10 %葡萄糖 1ml和 3%麻黄素 1ml配成重比重溶液。用DurasafeTM型联合阻滞配套针于L3 4 间隙穿刺。以 0 .1ml/秒的速率蛛网膜下腔给药 1.5 2ml,术中酌情于硬膜外给予 2 %利多卡因维持麻醉。比较三组病人在感觉、运动阻滞及恢复上的异同 ,并观察用药后的不良反应。结果 罗哌卡因组的最大阻滞时间比地卡因组长而感觉恢复时间比地卡因组短 ,与布比卡因组相似 ;运动阻滞起效时间和最大运动阻滞时间比其它两组长 ,最大Bromage评分明显小于其它两组(P <0 .0 1) ,运动恢复时间短于布比卡因组 (P <0 .0 5 )和地卡因组 (P <0 .0 1)。主要的不良反应为恶心呕吐。结论 罗哌卡因用于腰麻 硬膜外联合阻滞是安全的 ,并能达到较为完善的麻醉效果。
Objective The double-blinded, randomly study was designed to determine the clinical efficacy and safety of ropivacaine for combined spinal-epidural anesthesia (CSE). Methods Sixty patients, ASA class Ⅰ-Ⅱ , 18 to 75 years, undergoing elective lower limb or perineum surgery, were randomly allocated to receiving spinally hyperbaric mixture 1.5-2ml of 1% ropivacaine (group R, n=20), 0.75% bupivacaine(group B,n=20), or 1% tetracaine (group T,n=20), combined with 10% glucose 1ml and 3% ephidrine 1ml respectively,and the anesthesia was maintained with epidural administration with 2% lidocaine if necessary during the operation ,after the B-D DurasafeTM combined spinal epidural anesthesia kit was applied at the L 3-4 interspace.Results The time to maximum spread of anesthesia in group R was longer, but the recovery time was shorter than those in group T(P<0.05) , those were similar to in group B(P>0.05). Additionally, as compared with ones in group B and T, the onset of motor block and the time to peak motor block were prolonged significantly (P<0.05),the maximum modified Bromage scale was decreased statistically (P<0.01),the recovery time of motor block was shortened (P<0.05 or 0.01) in group R. All patients were recovered uneventfully and no unexpected adverse effects were found throughout the whole procedures. Conclusions 1% ropivacaine is safe and effective for combined spinal-epidural anesthesia.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2000年第1期26-28,共3页
Chinese Journal of Anesthesiology
关键词
罗哌卡因
腰麻
硬膜外麻醉
联合麻醉
Bupivacaine
Tetracaine
Ropivacaine
Combined spinal-epidural anesthesia
Anesthesia
