罗哌卡因与布比卡因腰麻用于剖宫产手术的比较

Comparison of Ropivacaine and Bupivicaine for Spine Anesthesia in Patients Undergoing Cesarean Section

目的:研究相同剂量的罗哌卡因与布比卡因腰麻用于剖宫产手术的效应对比,探讨罗哌卡因腰麻用于剖宫产手术的有效性和安全性.方法:选择40例ASAⅠ-Ⅱ级行腹膜外剖宫产病人,22岁-39岁,随机分成两组.用0.75％罗哌卡因和布比卡因各2ml,分别加入10％葡萄糖1ml配成重比重溶液.采用25G腰麻穿刺针,于L3-L4间隙穿刺.在15s内恒速注入蛛网膜下腔药液2ml.比较两组病人在感觉、运动阻滞及恢复上的异同,由手术医生评定术中胍松程度,由病人评定镇痛情况,并观察病人用药后的不良反应.结果:两组病人的感觉阻滞起效时间、恢复时间、最高阻滞平面、最大阻滞时间无显著差异;罗哌卡因组的运动阻滞起效时间和最大运动阻滞时间比布比卡因组长(P<0.05),最大Bromagc评分也明显小于布比卡因组,运动恢复时间小于布比卡囡组(P<0.05).镇痛效果及肌松程度两组无显著差异(P>0.05).两组出现的心动过缓、低血压等不良反应发生相似. 结论:罗哌卡因可以安全、有效地用于腰麻下行剖宫产手术.

Objective: To compare the effective of the same dose of ropivacaine and bupivicaine for cesarean section and evaluate the efficacy and safety of ropivacaine for spine anesthesia undergone cesarean section. Methods: 40 (ASA-Ⅱ) patients for beside peritoneum cesarean section were divided into 2 groups: ropivacaine group received 0.75% ropivacaine 2 ml and bupivicaine group received 0.57% bupivicaine 2 ml for spinal anesthesia. The difference of sensory block, motor block and recovery was compared. Muscle relaxation degree was assessed by operator doctor, qualiry analgesia were assessed by patients and observation the side reaction. Results: There was no significant difference between the two groups in the onset time, recovery time, the height of block and the longest duration time of sensory block. The onset time and duration time of motor block were longer in ropivacaine group. The Bromage grade and the recovery time were short in ropivacaine group. There was no significant difference berween the 2 groups in quality analgesia and muscle relaxation degree. There were similar din bradycardia and hypotensive between 2 groups. Conclusion: Ropivacaine for spinal anesthesia undergoing cesarean section might be effective and safe.