不同浓度罗哌卡因硬膜外阻滞行乳腺癌根治术的临床观察

The clinical observation of epidural analgesia with different concentrations of ropivacaine in patients undergoing radical mastectomy

目的通过观察不同浓度罗哌卡因高位硬膜外阻滞行乳腺癌根治术的镇痛效果和对呼吸循环功能的影响,探讨罗哌卡因高位硬膜外阻滞的合适浓度。方法选择45例择期硬膜外阻滞行乳腺癌根治术的患者,随机分为A、B、C三组,各15例,分别注射0.25%、0.375%和0.5%罗哌卡因,观察记录三组的镇痛效果以及MAP、HR、RR和SpO2的变化。结果镇痛效果:B、C组优于A组,三组麻醉后MAP和HR均显著下降,C组RR和SpO2有显著下降,差异有统计学意义。结论0.375%罗哌卡因硬膜外阻滞行乳腺癌根治术对呼吸循环影响小,安全可行。

Objective To observe the effect to analgesia and the function of respiratory-circulation of the high thoracic epidural anesthesia in patients undergoing radical mastectomy with different concentrations of ropivaeaine, discuss the proper concentration of ropivacaine in the high thoracic epidural anesthesia. Methods 45 patients undergoing radical mastectomy were divided into A, B and C groups randomly. Each has 15 cases. Group A was received epidural anesthesia with 0. 25% ropivacaine, Group B with 0. 375% ropivacaine and Group C with 0. 5% ropivacaine. The indexes needed to be recorded are as follows：MAP, HR, RR and SpO2. Results The analgesia effect in Group B and C is better than Group A. RR and SpO2 in Group C has dropped obviously. Conclusion Epidural anesthesia with 0. 375% ropivacaine in patients undergoing radical mastectomy is safe and effective.