碳酸利多卡因与盐酸利多卡因复合盐酸罗派卡因用于硬膜外麻醉的效果比较

Comparison of the effects of lidocaine carbonate with lidocaine hydrochloride combined ropivacaine hydrochloride in epidural anesthesia

目的比较碳酸利多卡因与盐酸利多卡因复合盐酸罗派卡因用于硬膜外麻醉的效果。方法选择拟行阑尾切除术的患者80例,随机均分为T组和Y组,各40例。分别予1.72%碳酸利多卡因7.5ml复合1%盐酸罗派卡因7.5ml行硬膜外麻醉(T组),2%盐酸利多卡因7.5ml复合1%盐酸罗派卡因7.5ml行硬膜外麻醉(Y组)。两组患者均选择T12～L1行硬膜外穿刺、置管,注入2%盐酸利多卡因3ml作为试验剂量,再注入10ml局麻药作为初始量。两组患者在术后进行视觉模拟(VAS)疼痛评分、舒适度(BCS)评分、术者满意度(视觉模拟评分,VAS评分)以评价药物治疗效果。监测并记录麻醉起效时间、麻醉不良反应,感觉神经阻滞情况(采用针刺皮肤法)、切皮前运动神经阻滞情况(采用Bromage评分法)和入室(T0)、术前(T1)、切皮(T2)、术毕(T3)的HR、MAP、SpO2及呼吸频率(f)。结果两组患者麻醉不良反应及MAP、HR、呼吸频率(f)、SpO2组间比较差异无统计学意义。术后VAS疼痛评分T组低于Y组(P<0.05),BCS评分T组高于Y组(P<0.05)。T组感觉阻滞起效时间、达最高平面时间显著短于Y组(P<0.05)。切皮前T组运动神经阻滞程度优于Y组(P<0.05)。T组麻醉起效时间短于Y组(P<0.05)。T组术者满意度优于Y组(P<0.05)。结论碳酸利多卡因复合盐酸罗派卡因用于硬膜外麻醉的效果优于盐酸利多卡因。

Objective To compare the effects of lidocaine carbonate with lidocaine hydrochloride compound ropivacaine hydrochloride in epidural anesthesia.Methods Eighty patients undergoing appendix section,were randomly divided into two groups with 40 cases in each group,with 1.72% lidocaine carbonate 7.5ml compound 1% ropivacaine hydrochloride 7.5ml for epidural anesthesia in Group T,with 2% lidocaine hydrochloride 7.5 ml compound 1% ropivacaine hydrochloride 7.5ml for epidural anesthesia in Group Y.Tow groups all applied epidural anesthesia,punctured in T12 ～ L1,putted leader,injected 3ml 2% lidocaine hydrochloride as test dose into epidural space,and the injected 10 ml local anesthetic as initial dose.The visual analog scale（VAS） of postoperative pain,Brurggmann comfort scale（BCS） and the satisfaction of physicians（VAS） were compared between the tow groups.The onset time,the incidence of side effects,sensory nerve block state（applied acupuncture skin method） and motor nerve block state before cutting skin（graded by Bromage） were recorded.HR,MAP,SpO2,f were recorded at time of entering the operating room（T0）,before the operation（T1）,skin incision（T2）,at the end of operation（T3）.Results The incidence of side effects,HR,MAP,f and SpO2 were no obvious difference in tow groups（P0.05）.The visual analog scale（VAS） of postoperative pain of group T were lower than group Y（P0.05）.The Brurggmann comfort scale（BCS） were higher than group Y（P0.05）.The effective time and max segment time of sensory nerve block of group T were significantly shorted than group Y（P0.05）.The motor nerve block state of group T was significantly effective than group Y before cutting skin（P0.05）.The satisfaction of physicians of group T were better than group Y（P0.05）.Conclusion Lidocaine carbonate compound ropivacaine hydrochloride in epidural anesthesia is more effective than Lidocaine hydrochloride.