甲磺酸罗哌卡因和盐酸罗哌卡因用于腰丛-坐骨神经联合阻滞的比较

Comparison of ropivacaine mesylate and ropivacaine hydrochloride for lumbar plexus combined with sciatic nerve block

目的比较甲磺酸罗哌卡因和盐酸罗哌卡因用于腰丛-坐骨神经联合阻滞行单侧下肢手术的麻醉效果和安全性。方法选择ASAⅠ～Ⅱ级行单侧下肢手术患者45例,随机分为两组,均在周围神经刺激器(PNS)引导下行腰丛和坐骨神经联合阻滞,Ⅰ组(23例)注入0.596%甲磺酸罗哌卡因45ml,Ⅱ组(22例)注入0.5%盐酸罗哌卡因45ml。注药完毕后,观察平均动脉压及心率的变化情况,测定并记录下肢感觉及运动阻滞起效、维持时间,观察术后麻醉相关并发症及不良反应,对麻醉满意度进行综合评价。结果两组间下肢感觉及运动阻滞起效和维持时间差异无统计学意义(P>0.05);平均动脉压、心率及麻醉满意度综合评价组间差异无统计学意义(P>0.05);两组未见严重的不良反应或并发症。结论0.596%甲磺酸罗哌卡因在腰丛-坐骨神经联合阻滞中与盐酸罗哌卡因具有相似的麻醉效应及安全性,为临床麻醉工作提供了更多一种选择。

Objective To evaluate the clinical efficacy and safety of Lumbar plexus combined with sciatic nerve block by using 0. 596% Ropivacaine Mesylate compared with 0.5% Ropivacaine Hydrochloride for unilateral lower limb surgery. Methods Forty five ASA grade Ⅰ - Ⅱ patients undergoing unilateral lower limb surgery were randomized into two groups. Group Ⅰ （n：23） received 45 ml of 0. 596% Ropivacaine Mesylate and group Ⅱ （n=22） received 45 ml of 0.5% Ropivacaine Hydrochloride. Combined lumbar plexus and sciatic nerve block was guided by Peripheral nerve stimulator. The time to onset of sensory and motor block, the duration of sensory and motor block, pulse rate, MAP, and complications were recorded after injection. we assessed the anesthetic quality after operation. Results There were no significant differences between the two groups in time to onset of sensory and motor block, duration of sensory and motor block, pulse rate, MAP and anesthetic quality. There were no major postoperative side effects or complications in either group. Conclusion The similar analgesic effects and safety are in both 0. 596% Ropivacaine Mesylate and 0.5 % Ropivacaine Hydrochloride groups for lumbar plexus combined with sciatic nerve block. It is a better choice for clinical anesthesia.