摘要
目的探讨与0.5%盐酸罗哌卡因比较等摩尔甲磺酸罗哌卡因骶管阻滞用于肛肠手术的麻醉效果和安全性。方法60例ASAⅠ～Ⅱ级择期肛肠手术患者随机分为两组:A组(甲磺酸罗哌卡因组)、B组(盐酸罗哌卡因组)。入室开放静脉通路,连续监测BP、P、SpO2、ECG、RR。俯卧位行改良骶管阻滞,两组患者均以1%盐酸利多卡因5mL作为试验剂量,3min后无不良反应则分别给予0.596%甲磺酸罗哌卡因、0.5%盐酸罗哌卡因各20mL。记录麻醉效果(感觉神经阻滞起效时间、最高平面、持续时间及运动神经阻滞程度)、术中生命体征的变化情况、不良反应、麻醉满意度。术后进行随访。结果甲磺酸罗哌卡因比盐酸罗哌卡因感觉阻滞起效时间短([7.9±3.3)minVS(11.2±3.5min)],前者吸收快,易出现轻度局麻药毒性反应。两者感觉阻滞持续时间[6.4±1.3)hVS(6.5±1.1)h]、运动阻滞程度无明显差异,生命体征变化、麻醉满意度无明显差异。结论0.596%甲磺酸罗哌卡因骶管阻滞下实施肛肠手术起效快,感觉阻滞完善。
Objective To compare 0.5% hydrochloride ropivacaine,mesylate ropivacaine with the same molanesthetic effect and safety on caudal block in anorectal surgery. Methods 60 cases of patients with ASA Ⅰ - Ⅱ degree who have the anorectal surgery were randomly divided into two groups： Group A（mesylate ropivacaine）; Group B （hydrochloride ropivacaine）. Open vein access respectively at the time of admission,and monitoring BP,P,SpO2,ECG,RR continuously. Prone position improves sacral block. Two group patients were infused 5mL 1% hydrochloride ropivacaine as a test and they had not adverse reaction 3 minutes later,and then 0.596% mesylate ropivacaine or 0.5% hydrochloride ropivacaine 20mL respectively. Taking record of the anesthetic effect（the onset time of sensory nerve block,the highest plane, duration and extent of motor nerve block）, changes of vital signs during surgery, adverse reaction, satisfaction in anaesthesia, follow-up after surgery. Results The onset time of sensory nerve block of mesylate ropivacaine is shorter than that of hydrochloride ropivacaine. The former could be assimilated faster and it is easier to be appeared light local anaesthesia virulence reaction. There was no evident difference in blockage duration, motor blockage degree;and there was also no evident difference in changes of vital signs and satisfaction in surgery. Conclusion Operating anoreetal surgery by caudal block with 0.596% mesylate ropivacaine could effect faster and sense blockage is perfect.
出处
《中国现代医生》
2009年第18期179-180,188,共3页
China Modern Doctor
