0.5%罗哌卡因等比重腰麻在前列腺等离子电切术的应用

Isobaris 0.5% ropivacaine as a local anesthetic for spinal anesthesia in transurethral plasma kinetic resection of prostate.

目的观察0.5%罗哌卡因等比重腰麻用于前列腺等离子电切术的麻醉效果。方法选择100例ASAⅠ～Ⅱ级,择期行前列腺等离子电切术的老年患者,随机分为两组,罗哌卡因组(R组)布比卡因组(B组)。R组、B组等比重腰麻0.5%罗哌卡因与布比卡因的剂量均为12.5mg,观察两组感觉运动神经阻滞情况,麻醉效果以及不良反应。结果 R组感觉运动阻滞起效时间明显比B组时间长(P<0.05),最高痛觉阻滞平面明显比B组低(P<0.05),痛觉阻滞,运动阻滞持续时间明显比B组短(P<0.05),运动组滞R组明显比B组弱(P<0.05),R组罗哌卡因麻醉效果明显比B组差(P<0.05),R组有10例患者术中需要静脉补充芬太尼0.1mg。两组不良反应发生率都很低,差异无统计学意义(P>0.05),两组中均无麻醉失败患者。结论等比重腰麻0.5%罗哌卡因用于前列腺等离子电切术麻醉效果不及布比卡因确切,但仍然是临床可供选择之一。

Objective To observe the effect of isobaric 0.5% ropivacaine as local anesthetic for spinal anesthesia in transurethral plasma kinetic resection of prostate.Methods 100 ASA Ⅰ or Ⅱ senil patients undergoing elective transurethral plasma kinetic resection of prostate were randomly divided into 2 groups（n=50 each）：group ropivacaine（group R）,group bupivacaine（group B）.The dose of 0.5% ropivacaine or bupivacaine of each group were both 12.5mg.Sensory and motor blockade,effect,adverse reaction of local anesthetic were recorded.Results Onset time of sensory and motor blockade in group R was longer than in group B（P0.05）,Cephalad spread of sensory blocks was lower in group R（median level,pinprick T9） than in group B（pinprick T7）（P0.05）.Total duration of sensory and motor blockade in group R was shorter than in group B.The ropivacaine provided less potent motor effects and anesthesia than bupivacaine for transurethral plasma kinetic resection of prostate.Ten patients in group R received iv fentanyl 0.1mg.The incidence rate of adverse reaction was similar and little in two groups（P0.05）.The ropivacaine and bupivacaine both provided suceesesful anesthesia in two groups.Conclusion Isobaric 0.5% ropivacaine as a local anesthetic for spinal anesthesia provided less potent anesthesia than bupivacaine in transurethral plasma kinetic resection of prostate,but it still remained to be choosed in clinical anesthesia.