用0.75%罗哌卡因硬膜外麻醉方法进行骨髓采集术的临床观察

The clinical observation of 0.75% Ropivacaine in epidural anesthesia for adopting bone marrow

目的对照1%利多卡因+0.25%地卡因合剂,观察0.75%罗哌卡因硬膜外麻醉应用于骨髓采集术的效果。方法60例健康骨髓供者,硬膜外注药时随机分别接受0.75%罗派卡因(R组30例)及1%利多卡因+0.25%地卡因合剂(LD组30例)麻醉,观察感觉阻滞(针刺法)、运动阻滞(Bromage分级),评价镇痛效果,连续监测心率、血压、潮气量、呼吸频率的变化。结果R组感觉阻滞时间短于LD组(达T10、最高麻醉平面的时间),R组运动阻滞时间明显迟于LD组,R组对循环、呼吸的影响小于LD组,P均<0.05,两组均无严重不良反应。结论0.75%罗哌卡因硬膜外麻醉用于骨髓采集术,其阻滞效果较为理想,对循环、呼吸的影响均小于1%利多卡因+0.25%地卡因合剂。

Objective To investigate the effect of 0.75%Ropivacaine compared with the mixture of 1%Lidocaine +0.25%Tetracaine in epidural anesthesia for adopting bone marrow.Methods 60 patients for supplying bone marrow were divided into two groups randomly,group R:0.75%Ropivacaine(n=30),group LD: the mixture of 1%Lidocaine +0.25%Tetracaine(n=30).All the patients were in epidural anesthesia. To observe sensory nerve block、motor nerve block、evaluating the effect of analgesia、continuous monitoring PR、BP、tidal volume(TV)、respiratory rate(RR)and adverse reaction.Results The time of group R was shorter than group LD in sensory nerve block and longer than group LD in motor nerve block.The observing of group R was obtained with less changes of pressure、heart rate and TV、RR. There were no serious side effects in two groups.Conclusion 0.75%Ropivacaine is better than the mixture of 1%Lidocaine +0.25%Tetracaine in epidural anesthesia for anesthesia for adopting bone marrow.