不同浓度罗哌卡因用于小儿骶管麻醉的效果评价

Efficacy of Ropivacaine with Various Concentrations in Children's Caudal Anesthesia

目的观察不同浓度罗哌卡因用于小儿骶管阻滞的效果。方法ASAI^II级会阴部小手术患儿80例,随机分为4组,每组20例:R1组(0.2%罗哌卡因,1mL.kg-1),R2组(0.25%罗哌卡因,1mL.kg-1),R3组(0.3%罗哌卡因,1mL.kg-1),R4组(0.375%罗哌卡因,1mL.kg-1),行骶管阻滞,骶管阻滞前给予异丙酚1mg.kg-1,术中麻醉效果欠佳者静脉注射氯胺酮。记录术中患儿的血压、心率、呼吸频率、脉搏氧饱和度及辅助静脉麻醉药的用量。进行运动力量和反射评分(MPRS)、疼痛/不适评分(PDS)。结果4组患儿血压、心率、呼吸频率、脉搏氧饱和度差异无显著性。术中辅助麻醉药用量R1组>R2组>R3组>R4组。MPRS评分R1组>R2组、R3组>R4组,R2组、R3组差异无显著性。PDS评分R1组>R2组,R3组>R4组。结论0.3%罗哌卡因用于小儿骶管阻滞,镇痛效应好,不良反应少,适用于小儿会阴部手术。

Objective To observe the caudal block effect of ropivacaine with various concentrations in children. Methods Eighty short perineum surgery pediatric patients were randomized into four groups evenly： R1 group （treated with 0. 2% ropivacaine, 1 mL·kg^-1 ）, R2 group （ treated with 0.25% ropivacaine, 1 mL·kg^-1）, R3 group （ treated with 0.3% ropivacaine. 1 mL·kg^-1 ） and R4 group （ treated with 0. 375% ropivacaine, 1 mL·kg^-1）. Ropivacaine was given after 1 mg·kg^-1 propofol administrated iv as inducing anaesthesia. Ketamine were given intravenously in necessity. Blood pressure, heart rate, respiratory rate, SpO2, and the dosage of ketamine were recorded during the surgery. Motor power and reflex scale （MPRS） scores and pain/discomfort scale （PDS） scores were tested. Results Blood pressure, heart rates, respiratory rate and SpO2 had no significant difference among the four groups. The dosages of ketamine were significantly decreased in the following order：R1 group〉 R2 group or R3 group 〉 R4 group （P 〈0.05）. The MPRS scores in R2 group and in R3 group had no significant difference. The PDS scores were in the order ： R1 group〉 R2 group or R3 group 〉 R4 group （ P〈 0.05 ）. Conclusion The results indicate that 0.3% ropivacaine solution is the best in child caudal block with good analgesia and minimal side effects.