摘要
目的比较左旋布比卡因与布比卡因在臂丛神经阻滞中的药效学特性.方法60例上肢手术患者,ASA Ⅰ～Ⅱ级,随机分成三组,Ⅰ组为0.375%布比卡因,Ⅱ组为0.375%左旋布比卡因,Ⅲ组为0.375%左旋布比卡因加1:200 000肾上腺素.肌间沟法行臂丛神经阻滞.观察阻滞起效时间及持续时间、神经阻滞节段数、术中镇痛质量、不良反应以及注药前、注药后5、10、30、60 min时心率(HR)和平均动脉压(MAP).结果Ⅱ、Ⅲ组麻醉起效时间短于Ⅰ组(P＜0.05);麻醉持续时间Ⅱ、Ⅲ组长于Ⅰ组但差异无显著性,Ⅱ、Ⅲ组间比较差异无显著性;各组阻滞节段数、术中牵拉痛发生率、HR及MAP差异无显著性;Ⅰ组寒战发生率高于Ⅱ、Ⅲ组(P＜0.05).结论左旋布比卡因有与布比卡因相似的药效学特性,可安全用于临床臂丛神经阻滞;肾上腺素不延长左旋布比卡因的麻醉持续时间.
Objective To observe the pharmacodynamics of levobupivacaine and bupivacaine in brachial plexus block. Methods Sixty ASA Ⅰ - Ⅱ patients undergoing upper limb surgery under brachial plexus block were divided randomly into three groups with 20 cases each. Group Ⅰ received 0.375% bupivacaine;group Ⅱ 0. 375% levobupivacaine;group Ⅲ in which 1 ： 200000 adrenaline was added to 0.375% levobupivacaine. The volume of local anesthetics is 30 rnl in each group. Anesthesia was performed by interscalene brachial plexus block. The onset and duration of analgesia,the level of block as well as adverse effects were recorded. HR and MAP were measured before anesthesia, 5,10, 30 and 60 min after anesthesia. Results The onset time of block was significantly shorter and shivering was significantly lower in group Ⅱ and Ⅲ as compared with group Ⅰ. There was no significant difference in the duration of anesthesia, the level of block, the incidences of visceral pain, HR and MAP, among three groups. Conclusion Levobupivacaine,of which the pharmacodynamics is similar to that of bupivacaine,can be used in clinical brachial plexus block safely,and adrenaline can not prolong it＇s duration of anesthesia.
出处
《临床麻醉学杂志》
CAS
CSCD
2005年第11期763-764,共2页
Journal of Clinical Anesthesiology
