摘要
目的客观分析和判定在玻璃体视网膜手术中布比卡因和罗哌卡因分别与利多卡因混合进行球后麻醉的效果。设计前瞻性比较性病例系列。研究对象93例接受23G玻璃体切除术的患者通过随机数字表法平均分入A、B、C三组,每组31例(31眼)。方法对每组患者球后麻醉注射不同局麻药物,其中A组注射2%利多卡因2.25 ml和0.5%布比卡因2.25 ml混合溶液,B组注射2%利多卡因3 ml和1%罗哌卡因1.5 ml混合溶液,C组注射2%利多卡因溶液4.5 ml,观察术中麻醉效果和术后疼痛情况。主要指标术中感觉阻断时间、运动失能开始时间、术后疼痛开始时间、麻醉效果评价。结果 A、B、C三组的平均感觉阻断时间分别为(2.10±0.10)分钟、(2.13±0.11)分钟、(2.14±0.13)分钟,组间比较无统计学差异(F=0.800,P=0.456)。三组的平均运动失能开始时间分别为(3.10±1.16)分钟、(3.63±1.11)分钟、(3.24±1.63)分钟,组间比较无统计学差异(F=2.000,P=0.138)。三组的术后疼痛开始时间分别为(140.57±22.23)分钟、(134.44±26.34)分钟、(87.34±26.53)分钟,组间比较有统计学差异(F=3.500,P=0.035),其中A组和B组较C组明显延长(t=8.5626,7.0146,P均=0.0001)。A、B、C三组中麻醉效果评级达到5级的患者人数分别为18例、14例和9例(A组与B组比较:χ~2=1.0300,P=0.3090;A组与C组比较:χ~2=5.3100,P=0.0210;B组与C组比较:χ~2=1.7300,P=0.1890)。结论罗哌卡因联合利多卡因进行玻璃体视网膜手术的麻醉,具有和布比卡因联合利多卡因基本同等的麻醉效果和持续时间,优于单独使用利多卡因进行麻醉。
Objective To analyse and judge the anesthetic effect of lidocaine combined with bupivacaine or ropivacaine in retrobulbar anesthesia in vitreo-retinal surgery. Design Prospective comparative case series. Participants 93 patients treated by 23G were randomly divided into A, B, C groups. Methods For each group, 31 patients underwent retrobulbar anesthesia with different anesthesia drugs （group A： 2% lidocaine 2.25 ml combined with 0.5% bupivacaine 2.25 ml; group B： 2% lidocaine 3 ml combined with 1% ropivacaine 1.5 ml; group C： 2% lidocaine 4.5 ml）. The intraoperative anesthestic effect and postoperative pain was recorded. Main Outcome Measures Time of onset of analgesia, akinesia, and intraoperative pain. Results Mean time of onset of sensory blockade for the three groups were 2.10±0.10 min, 2.13±0.11 min and 2.14±0.13 min respectively, there was no significant difference （F=0.800,P=0.456）. Mean time of onset of motor blockade for the three groups were 3.10±1.16 min, 3.63±1.11 min and 3.24±1.63 min respectively, there was no significant difference （F=2.000,P=0.138）. Mean time of onset of intraoperative pain of three groups were 140.57±22.23 min, 134.44±26.34 min and 87.34±26.53 min respectively, there was significant difference （F=3.500,P=0.035）. The time of onset of intraoperative pain of Group A and B was longer than Group C （t=8.5626, 7.0146; all P=0.0001）. The number of patients with anesthesia effect rating at level 5 in the three groups was 18, 14 and 9 respectively. Conclusion Lidocaine combined with ropivacaine has the equal anesthesia effect and duration compared to lidocaine combined with bupivacaine. The effect is better than that of using lidocaine anesthesia alone.
出处
《眼科》
CSCD
北大核心
2017年第2期139-142,共4页
Ophthalmology in China
关键词
利多卡因
布比卡因
罗哌卡因
球后麻醉
lidoeaine
bupivaeaine
ropivacaine
retrobullbar anesthesia
