左旋布比卡因行腰-硬联合麻醉于下肢骨科手术麻醉的研究

目的:探讨左旋布比卡因行腰-硬联合麻醉用于下肢骨科手术的麻醉效果和安全性。方法:下肢骨科手术80例,随机等分为两组,患侧向下侧卧,L3～4腰硬联合阻滞。对照组用0.75%布比卡因(B)2ml(15mg),加10%葡萄糖注射液1ml后单次注射,注速1ml/15秒,注药后保持原位15分钟后仰卧。实验组用0.75%左旋布比卡因(LB),其他与对照组完全相同。结果:①两组比较,阻滞特征的6项指标中除运动阻滞持效时间LB组较短有显著性差异(P<0.05)外,其余指标无显著性差异(P>0.05)。②两组的阻滞前后平均动脉压和心率的变化均无显著性差异(P>0.05)。③两组的单侧阻滞率均为100%,且单侧阻滞均完善。结论:LB和B单侧腰麻的阻滞特征除运动阻滞持效时间LB较短外基本一致,对循环的干扰均较轻,二者应可任选。使用左旋布比卡因行腰-硬联合麻醉于下肢骨科手术是安全有效的。

Objective：To observe the efficacy and safety of combined spinal-epidural an-esthesia（CSEA） with levobupivacaine on the operation of lower extremities.Methods：80 patients scheduled for lower limb fracture surgery were randomly divided into 2 groups,In one group the patients were asked to lie on the compromised side for slow in-jection of Hyperbaric bupivacaine solution（0.75% 15mg, diluted to 3ml with 10%glucoseinjection） at the rate of 1 ml/15 sthrough a 27-gauge needle.The patients maintained their position for 15分钟before shifting to a supine position. In the other group levobupivacaine was used instead.Results：Statistical study showed that the block characteristics were of no significant difference between the 2 groups （P0·05） ex-cept that the duration of motor block was shorter in levobupivacaine group than in bupivacaine group（P0·05）.Blood pres-sure or heart rate showed no significant difference between the two groups during op-eration. Conclusion： The block characteris-tics of hypobaric unilateral spinal block with levobupivacaine or bupivacaine are similar and their effect on circulatory function isslight. Levobupivacaine provides an option in case bupivacaine is not available