罗哌卡因迷走神经阻滞预防术中哮喘发作的效果

EFFECT OF VAGAL BLOCK BY ROPIVACAINE ON PREVENTION OF BRONCHIAL ASTHMA DURING OPERATION

目的了解并发支气管哮喘的肺部病变病人胸腔镜手术中，用罗哌卡因阻滞迷走神经对预防支气管哮喘发作的效果。方法对15例并发支气管哮喘病人在全麻双腔气管插管下行胸腔镜手术，手术中在胸腔镜明视下于肺门处均匀注射5g／L罗哌卡因10～15mL阻断迷走神经及其分支，冲洗胸腔后关胸前再注射1次。记录阻滞前后病人的临床症状、动脉血气分析、肺功能变化。结果与阻滞前比较，阻滞后病人临床症状明显改善，PaO2上升，差异均有显著性（uc=3．700～3．946，P％0．01；t=3．911，P〈0．01）。结论胸腔镜手术中用罗哌卡因阻滞迷走神经可有效预防支气管哮喘发作，无副作用。

Objective To observe the effect of vagal block using ropivacaine on preventing the attack of bronchial asthma during thoracoscopy. Methods Thoracoscopy was performed in 15 brachial asthma patients under general anesthesia, ropivacaine （5 g/L, 10-15 mL） was injected at the hilum of the lung, under direct vision, to block the vagus and its branches. One more injection was given before closing thoracic cavity. The patients＇ symptoms, blood gas, lung function, before and after the block, were recorded. Results Compared with before vagal block, the clinical symptoms improved, and PaO2 rised （uc = 3. 700- 3. 946,P〈0.01;t=3. 911 ,P〈0. 01）. Conclusion Vagal block with ropivacaine during thoracoscopic operation can effectively prevent the attack of bronchial asthma without side effects.