0.5%罗哌卡因与0.5%布比卡因在小儿脊麻中的应用

Application of ropivacaine 0.5% with bupivacaine 0.5% for spinal anaesthesia in children

目的观察 0 .5 %罗哌卡因应用于小儿脊麻中的安全性和有效性。方法随机选择ASAI～II级患者 4 8例 ,分为R组(0 .5 %罗哌卡因 )和B组 (0 .5 %布比卡因 ) ,每组 2 4例 ,用药后分别记录痛觉、温觉、运动神经阻滞的起效时间 ,痛觉阻滞平面 ,运动阻滞时间和程度以及术后首次排尿时间 ,术中测定BP、SpO2 、EKG、HR及CSF的pH值 ,术后定时随访。结果选用罗哌卡因后各病例均能迅速恢复运动 ,术始运动神经阻滞未大于BromageⅠ ,但R组却有 5例因痛觉阻滞不佳而改用其他麻醉。结论相同剂量的 0 .5 %罗哌卡因用于小儿脊麻中镇痛和感觉阻滞时间并不明显优与布比卡因 ,麻醉期间和术后的不良反应小于布比卡因 ,对于短小手术来说是一个安全有效的局麻药 。

Objective To evaluate the clinical safety and efficacy of 0.5% ropivacaine for spinal anesthesia and compare with 0.5%bupivacaine in children. Methods Forty -eight ASA I～II children, scheduled for low abdominal surgery and lower limb operations were randomly allocated into two groups. Group R was received 0.5% ropivacaine, Group B received 0.5%bupivacained. The onset time and duration, the upper level of analgesia, degree of motor block, and the first micturition were recorded. The vital signs of the kids were recorded during the surgery, pH of the CSF was also examinated. Results Patients in group R was recovered immediately after operation, the degree of the motor block was below than Bromage I, but 5 cases were changed the anesthesia due to unsatisfactory analgesia block. Conclusion When 0.5% ropivacaine used for spinal anesthesia, the analgesic efficacy is no better than bupivacaine, but its motor block is less and its complications are less. Ropivacaine is suitable for small operation under spinal anesthesia in children.