摘要
目的:研究罗哌卡因复合芬太尼用于腰麻-硬膜外联合阻滞的安全性和有效性。方法:择期行骨科下肢手术患者64例,18~80岁,ASAⅠ~Ⅱ级,随机分成两组:R(罗哌卡因)组,n=32,用1%罗哌卡因2 mL(20 mg)与脑积液1 mL,配成3 mL溶液;RF(罗哌卡因复合芬太尼)组,n=32,用1%罗哌卡因2 mL(20 mg)与芬太尼1 mL(50μg)配成3 mL溶液。用南昌贝欧特公司联合阻滞配套针于L2~L3间隙穿刺,以0.1 mL.s-1的速率蛛网膜下腔给药2.5~3 mL,术中酌情于硬膜外给予2%利多卡因与1%罗哌卡因1∶1混合液维持麻醉。比较两组患者在感觉、运动阻滞及恢复上的异同,并观察用药后的不良反应。结果:两组间感觉阻滞起效时间、最大运动阻滞程度无显著差异(P>0.05);RF组最高感觉阻滞平面显著高于R组(P<0.05),RF组运动阻滞起效时间显著短于R组(P<0.05),RF组感觉平面消失时间、患肢运动恢复时间显著长于R组(P<0.05)。主要的不良反应为血压下降。结论:罗哌卡因复合芬太尼用于腰麻-硬膜外联合阻滞是安全的,并能达到较为完善的麻醉效果。
OBJECTIVE： To study the efficacy and safety of ropivacaine-fentanyl for combined spinal-epidural anesthesia（CSE）.METHODS： A total of 64 patients undergoing scheduled lower limb surgery aged between and 80 years（ASAⅠ-Ⅱ grade） were randomized to either R group receiving the mixture（3 mL） of 1% ropivacaine [2 mL（20 mg）^（-1）] and cerebrospinal fluid（1 mL） or RF group receiving the mixture（3 mL） of 1% ropivacaine [2 mL（20 mg）^（-1）] combined with fentanyl（1 mL/50 microgram）.Lumbar puncture at L_2-L_3 interspace was performed using the needle in combined spinal-epidural anesthesia kit（from Nanchang Biotek.Co.）.Drugs（2.5～3 mL） were administered into subarachnoid space at a rate of 0.1 mL·s^（-1）,and the anesthesia during operation was maintained with a mixture of 2% lidocaine and 1% ropivacaine（1∶1） if necessary.The differences between the two groups in sensory block,motor block,recovery time and adverse drugs reactions were recorded.RESULTS： The differences between the two groups were insignificant in respect of the onset time of sensory block,the degree of maximum motor block（P0.05）.In RF group as compared with R group,the surface of maximum sensory block was significantly higher（P0.05）,the onset time of motor block was significantly shorter（P0.05）,and the extinction time of the surface of sensory and the recovery time of motor of the affected limbs were significantly longer（P0.05）.The drop of blood pressure was the major adverse reaction.CONCLUSION： Ropivacaine plus fentanyl is safe and effective for combined spinal-epidural anesthesia.
出处
《中国医院用药评价与分析》
2010年第1期52-54,共3页
Evaluation and Analysis of Drug-use in Hospitals of China
