罗哌卡因腰麻对下肢手术患者血流动力学的影响

The haemodynamic effects of ropivacaine on spinal anesthesia for inferior extremity surgery

目的评价等效剂量的罗哌卡因和布比卡因腰麻对下肢手术患者的血流动力学。方法择期下肢手术患者60例,ASAⅠ～Ⅱ级,随机分为罗哌卡因组和布比卡因组,每组30例,分别给予罗哌卡因15 mg和布比卡因10 mg腰麻,观察并比较2组患者的麻醉效果和麻醉前后的收缩压(SBP)、舒张压(DBP)、心率(HR)及血氧饱和度(SpO2)等。结果 2组麻醉效果均能满足手术需要,麻醉后的SBP、DBP、HR均低于麻醉前,低血压和心动过缓的发生率相当。麻醉前后的SpO2无显著性差异(P>0.05)。结论在下肢手术中用罗哌卡因腰麻未表现出血流动力学明显优势,但不良反应低于布比卡因组。

Objective To compare the haemodynamic effects of equipotent doses of ropivacaine and bupivacaine in spinal anaesthesia in adult patients with inferior extremity surgery.Methods Sixty inferior extremity surgery patients with American Society of Anesthesiologists（ASA） Ⅰ-Ⅱ were randomly divided into two groups,receiving an intrathecal injection of either 15 mg hyperbaric ropivacaine or 10 mg hyperbaric bupivacaine.Haemodynamic indexes,such as systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR） and pulse oxygen saturation（SpO2） were investigated.Anesthetic effects and side effects were also recorded.Results The anesthetic effects were similar in two groups,which can satisfy the demand of the surgeries.SBP,DBP and HR decreased after the block in both groups.The occurrence rates of hypotension and bradycardia were similar.The values of SpO2 had no significant difference between two groups（P0.05）.Conclusion Ropivacaine can provide reliable spinal anesthesia without significant haemodynamic advantage,but adverse drug reaction rate less than bupivacaine.