左旋布比卡因、布比卡因和罗哌卡因腰麻用于妇科手术的比较

Comparison of levobupivacaine with bupivacaine and ropivacaine in spinal anaesthesia during gynecologic operation

目的:观察左旋布比卡因在腰麻下妇科手术中的应用效果,并与相同剂量的布比卡因和罗哌卡因比较。方法:选择ASA～级妇科经腹手术病人90例,随机分成三组,每组30例,LB组予0.5%左旋布比卡因2mL,B组予0.5%布比卡因2mL,R组予0.5%罗哌卡因2mL行腰麻,观察各组感觉阻滞起效时间、运动阻滞起效时间、最高感觉阻滞平面、最高平面固定时间、腰麻维持时间和麻醉质量。结果:感觉阻滞起效时间、最高感觉阻滞平面、最高平面固定时间和麻醉质量三组间无显著性差异(P>0.05),运动阻滞起效时间LB组和B组相似,而明显短于R组(P<0.01),腰麻维持时间LB组和B组相似,而明显长于R组(P<0.01)。结论:左旋布比卡因用于腰麻下妇科手术可提供良好的麻醉效果,其麻醉作用与相同剂量布比卡因相似,而较罗哌卡因强。

Objective To observe the effect of levobupivacaine in spinal anaesthesia during gynecologic operation, and compare with bupivacaine and ropivacaine at the same dosage. Methods Ninety patients, ASA class Ⅰ-Ⅱ , undergoing gynecological abdominal operation, were randomly divided into 3 groups, 30 cases in group LB received 2 mL of 0. 5% levobupivacaine, 30 in group B received 0. 5% bupivacaine,and 30 in group R received 0.5% ropivacaine used in spinal anesthesia. The onset time of sensory and motor block,the height of sensory block, the fixed time of block, the durative time of spinal anesthesia and the quality of anesthesia were observed. Results The onset time of sensory block ,the height of sensory block ,the fixed time of block and the quality of anesthesia were no significant influence in 3 groups（P〉0.05）. The onset time of motor block in group LB was similar to that in group B,but shorter than that in group R significantly（P〈0. 01）. The durative time of spinal anesthesia was similar to that in group B,but significantly longer than that in group R （P〈0.01）. Conclusion Levobupivacaine can offer a good efficacy in spinal anesthesia during gynecologic operation,and its efficacy is similar to bupivacaine but stronger than ropivacaine at the same dosage.