不同剂量罗哌卡因腰硬联合麻醉用于子宫全切术的临床观察

The Clinical Observational Research on the Effectiveness of Differen Dosages of Ropivocaine Injected in Combined Spinal and Eqidual Anesthesia(CSEA)during Hysterectomy

目的:探讨不同剂量的罗哌卡因腰硬联合麻醉用于子宫全切术的麻醉效能及最佳剂量。方法:选择(32～53)岁的子宫全切术病人75例,随机均分为三组。A、B、C组依次应用5%重比重罗哌卡因12.5mg、15mg、17.5mg。观察镇痛起效时间、运动阻滞起效时间、最高痛觉阻滞平面、麻醉持续时间、最大运动阻滞程度、痛觉及运动恢复时间、用药后的不良反应。结果:三组镇痛起效时间、最高痛觉阻滞平面差异无统计学意义;运动阻滞起效时间C组比A组短(P<0.05),麻醉持续时间、痛觉和运动恢复时间C组>B组>A组(P<0.05);C组不良反应最多。结论:罗哌卡因重比重液15mg腰硬联合麻醉麻用于子宫全切术,可达到完善的镇痛效果,且较安全,不良反应少。

Objective：To evatuate the perfect dose of ropivocaine used to combined spinal and eqidual anesthesia（CSEA） in hysterectomy.Methods：Seventy-five patients,aged 32 to 52 years,were randomly allocated to three groups with 25 cases each.The patients in group A,B and C were given 12.5mg,15 mg,17.5mg of 0.5% hyperbaric ropivacaine solution,respectively.Motor and sensory blockade was evaluated,and adverse effects were recorded.Results：There was no significant difference in sensory block including onset time and maximum cephalad spread level among three groups（P〉0.05）;The onset time and duration of motor blockage in group C were shorter than those ingroup A （P〈0.05）;The duration of anesthesia in group B were more than those in group A,but less than those in group C （P〈0.05）,there was the most adverse effect in group C.Conelusion：The satisfactory clinical effectiveness can be obtained by injecting ropivocaine in CSEA during hysterectomy with the best clinical dosage of 15mg.