相同浓度罗比卡因与布比卡因用于颈神经丛阻滞的比较

A Comparative study on cervical plexus block with ropivacaine or bupivacaine

目的 评价相同浓度罗比卡因与布比卡因用于颈神经丛阻滞的麻醉效果。方法 4 9例ASAⅠ～Ⅱ级甲状腺肿物切除患者随机分为两组 ,罗比卡因组 (Ⅰ组 ) 31例 ,布比卡因组 (Ⅱ组 )18例 ,分别用 0 375 %罗比卡因和 0 375 %布比卡因 10ml阻滞颈浅丛神经 ,用 0 2 5 %罗比卡因和0 2 5 %布比卡因 10ml阻滞其深丛。记录麻醉效果及所产生的并发症 ,记录麻醉前 (T0 )、麻醉后即刻 (T1)、麻醉后的 5min(T2 )、10min (T3 )、15min (T4)、30min (T5)及手术结束 (T6)时的HR、SBP、DBP、MAP、SpO2 、RR、Mv、VT。结果 两组麻醉效果相同 ,产生的并发症也无显著性差异 (P >0 0 5 )。罗比卡因对抬头肌力的影响显著弱于布比卡因 (P <0 0 1)。两组HR麻醉后均有显著升高(P <0 0 5 ) ,SBP、DBP、MAP在T1～T5时有显著升高 (P <0 0 5 ) ,在T6时与T0 相比无显著性差异(P >0 .0 5 )。与T0 比较 ,两组SpO2 、RR、Mv和VT 在各时间点上无显著性差异 (P >0 .0 5 )。结论 0 .375 %罗比卡因和 0 .375 %布比卡因用于颈浅丛神经阻滞 ,0 .2 5 %罗比卡因和 0 .2 5 %布比卡因用于颈深丛阻滞均产生较好的麻醉效果。罗比卡因由于运动神经阻滞较弱 。

Objective To compare the clinical efficacy of ropivacaine and bupivacaine used in cervical plexus block. Methods Forty-nine patients (ASAⅠ-Ⅱ) undergoing excision of thyrophyma were randomly divided into two groups, ropivacaine group (groupⅠ, n=31) and bupivacaine group (groupⅡ, n=18). Patients received superficial cervical block with ropivacaine 0.375% in group Ⅰ or bupivacaine 0.375%10 ml in group Ⅱ. Deep cervical plexus block was performed with ropivacaine 0.25% in group Ⅰor bupivacaine 0.25%10 ml in group Ⅱ. The efficacy of anesthesia and the possible complications of cervical plexus block were recorded. HR, SBP, DBP, MAP, SpO 2, RR, Mv and V T during operation were recorded as well. Result There was no significant difference between groupⅠ and groupⅡ about the efficacy of anesthesia and the complications. But the motor block of cervical muslces in groupⅠ was significantly weaker than that in groupⅡ (P<0.01). HR, SBP, DBP and MAP increased significantly after cervical plexus block. SBP, DBP and MAP recovered when the operation completed. There were no significant changes in SpO 2, RR, Mv and V T(P>0.05). There was no significant difference between group Ⅰ and group Ⅱ in HR, SBP, DBP, MAP, SpO 2, RR, Mv and V T (P>0.05). Conclusion Both ropivacain and bupivacain produce a good cervical plexus block. Ropivacaine is more suitable for cervical plexus block due to its less motor block.