罗哌卡因与布比卡因用于下腹部手术脊麻的效果观察

A Comparison of Spinal Anesthesia Ropivacaine with Bupivacaine Used for Lower Abdominal Surgery

目的比较0．75％罗哌卡因与0．75％布比卡因用于下腹部手术患者脊麻的临床效果。方法择期下腹部手术患者40例，ASAⅠ／Ⅱ级，随机分为2组（n=20）：R组（罗哌卡因组），B组（布比卡因组）。选择L2-3间隙穿刺，将混合药液注入蛛网膜下腔。记录感觉阻滞及运动阻滞的起效时间及持续时间，脊麻后血流动力学指标的变化。术中不良反应的发生和处理情况。结果罗哌卡因对感觉神经的阻滞与布比卡因相比差异无统计学意义（P〉0．05），罗哌卡因对运动神经阻滞的起效时间长于布比卡因、而其对运动神经阻滞的持续时间短于布比卡因，其差异有统计学意义（P〈0．叭）。结论0．75％罗哌卡因用于脊麻是安全有效的，其镇痛时间与布比卡因相似，可以满足下腹部手术的要求，其对运动神经阻滞的持续时间短，有利于患者术后早期恢复。

Objective To compare the clinical efficacy of spinal 0.75 % ropivacaine with 0.75 % bupivacaine in patients with lower abdominal surgery. Methods 40 ASAⅠ/Ⅱ patients were randomly divided into 2 groups （n = 20 each） ：group R （the Ropivacaine group） and group B （the Bupivacaine group）. Spinal anesthesia was performed at L2-3 interspace. The onset time of sensory block and motor block, duration of analgesia and motor block were recorded. Hemodynamic, side-effects were also recorded. Results There was no significant difference in sensory block between the two groups （P〉0.05）. The onset time of motor block was significantly longer in group R than that in group B. The duration of motor block was significantly shorter in group R than that in group B. Conclusion 0.75% ropivacaine can give a satisfactory clinical effective（P〈0.01）. The duration of motor block was shorter in group R than that in group B. It is beneficial for patients to recovery quickly.