等浓度剂量罗哌卡因与布比卡因用于腰麻临床效果的比较

Comparison of clinical efficacy through epuidensity isconcen tration dose of ropivacaine mesylate and bupivacaine messy late in spinal anesthesia

目的观察等浓度剂量罗哌卡因与布比卡因用于腰麻的临床效果。方法ASA1—2级患者60例，随机分成两组0．5％罗哌卡因组（R组）和0．5％布比卡因组（B组），每组30例。两组均采用L2～3或L3—4穿刺蛛网膜下腔给药，R组给予0．5％罗哌卡因注射液2．0ml，B组给予0．5％布比卡注射液2．0ml。观察感觉、运动神经阻滞程度及恢复时间，同期连续监测血压、心率、麻醉效果和不良反应。结果两组在最高感觉阻滞平面差异无统计学意义（P〉0．05），R组较B组麻醉起效慢，维持时间短（P〈0．05），下肢运动神经阻滞程度R组显著低于B组（P〈0．01），B组舒张压与术前比较明显下降（P〈0．05）。结论2．0ml的0．5％罗哌卡因用于腰麻安全有效，与等浓度剂量布比卡因比较，起效慢，维持时间短，下肢运动神经阻滞弱，尿潴留发生率低。

Aim To observe the clinical effectiveness epuidensity isconcen-tration dose of ropivacaine mesylate and bupivacaine mesylate in spinal anesthesia. Methods Sixty ASA Ⅰ-Ⅱ patients were randomized into group R and group B. In all patients spinal space L2 - 3 or L3 -4 was punctured. Group R was given 0.5% ropivacaine mesylate 2.0 ml,group B was given 0.5% bupivacaine mesylate 2.0 ml. The effects of block , motor nerve block and time of recovery were monitored. BP, HR, anesthesia effects and side reaction was continu-ously recored during anesthesia. Results No significant differences were found in the absolute highest block level（P 〉 0.05）. The time to response of group R was longer than group B ,The anesthesia duration was shorter than group B. The level of the lower limb motor block in group R was sign-ificantly shorter than in group B（ P 〈 0.01 ）. DBP in group B was more significantly descended than before an- esthesias, （P 〈0.05 ）. Conclusion 2.0 ml 0.5% ropivacaine mesyiate can be safely used in spinal anesthesia compare to epuidensity isconcen-tration dose of bupivacaine mesylate , the level of the lower limb motor block is weaker and recovery more quickly, the time to response of group R is longer , the anesthesia duration is shorter, the incidence rate of Uroschesis is lower.