左旋布比卡因腰麻硬膜外联合阻滞麻醉在妇科手术的应用

Application of Levobupivacaine combined with spinal-pidural analgesia to gynaecologic surgery

目的:研究0.75%左旋布比卡因临床用于腰-硬联合隙阻滞麻醉的效果及安全性。方法:随机选择ASAⅠ～Ⅱ级的60例妇科腹式全子宫切除手术患者,随机均分成两组,A组:腰麻阻滞用药为0.75%左旋布比卡因15mg,容量为2.5ml;B组:腰麻阻滞用药为0.75%布比卡因,剂量及容量均同A组。两组术中视必要时经硬膜外导管注入2%盐酸利多卡因。围麻醉期监测BP,HR,SpO2,RR的变化并密切观察围麻醉期不良反应。结果:A、B两组达到最高阻滞平面及时间、阻滞麻醉持续时间、手术肌松效果及达到最大肌松效果时间差异均无显著意义。两组均无神经系统的不良反应。结论:0.75%左旋布比卡因用于腰-硬联合麻醉腹式全子宫切除手术安全有效,效果与0.75%布比卡因相比差异无显著意义。

Objective： To study the effect and safty of 0.75% Levobupivacaine used on clinical spinal-pidural analgesia.Methods： 60 ASA grade Ⅰ-Ⅱ patients with abdominouterotomy were randomly divided into Group A and Group B.2.5 ml of 0.75% Levobupivacaine（15 mg） was used in patients in Group A;and the same dose and volume of 0.75% Bupivacaine were applied to patients in Group B.If necessary,2% of Lidocaine Hydrochloride was injected the patients in bothe group through the epidural catheter while surgeries.The change of patients＇ BP,HR,SpO2 and RR were monitored and the adverse reaction was closely observed in the peri-anesthesia period.Results： There were no significant difference for the two groups as for the highest anaesthesia blockage plane,the time to reach it,block anesthesia time,muscle relaxation effect and the time to reach the highest muscle relaxation effect.Also,there was no adverse reactions in the nerve systems in both group.Conclusion： 0.75% of Levobupivacaine combined spinal-pidural analgesia applied to abdominouterotomy is safe,effective,whose effect is of no obvious difference from that of 0.75% of Bupivacaine.