罗哌卡因与布比卡因用于硬膜外阻滞麻醉效果的Meta分析

Application of ropivacaine and bupivacaine in epidural anesthesia： a Meta-analysis

目的评价罗哌卡因在硬膜外阻滞麻醉应用中的效果与安全性。方法检索PubMed、中国学术期刊全文等数据库中罗哌卡因与布比卡因在硬膜外阻滞麻醉的对比研究，利用Meta分析专用软件RevMan5．0进行系统评价，重点分析罗哌卡因与布比卡因在感觉阻滞起效时间、运动阻滞恢复时间以及低血压发生率间的差异。结果12项研究纳入Meta分析，其中罗哌卡因组362例，布比卡因组377例。罗哌卡因与布比卡因比较，具有较短的感觉阻滞起效时间（Z=2．24，P=0．02，I^2=20．5％。P〉0．05），与运动阻滞恢复时间（Z=5．70，P〈0．01，I^2=58．9％，P〉0．05），但两者低血压发生率差别无统计学意义（Z=1．06，P〉0．05。I^2=0，P〉0．05）。结论罗哌卡因麻醉效果确切，运动阻滞恢复快，具有较高的硬膜外阻滞麻醉优越性。

Objective To evaluate the efficacy and safety of ropivacaine in epidural anesthesia. Methods We searched PubMed and CNKI databases for studies which compared ropivacaine and bupivacaine in epidural anesthesia. The onset time of sensory block, duration of motor block, and incidence of hypotension were analyzed using RevMan 5.0 software. Results Twelve studies, including 362 cases receiving ropivacaine and 377 cases receiving bupivacaine were eligible for meta-analysis. Compared to the patients with bupivacaine, the onset time of sensory block （Z=2.24,P=0.02,I^2=20.5%,P〉0.05） and duration of motor block （Z= 5.70,P〈0.01 ,I^2=58.9% ,P〉0.05） was shorter in those with ropivacaine. No difference was observed in the incidence of hypotension between the two groups （Z=1.06,P〉0.05,I^2=0,P〉0.05）. Conclusions Considering the definite effect of ropivacaine, as well as its rapid recovery in epidural anesthesia, it may be a better choice during epidural anesthesia.