小剂量低浓度罗哌卡因腰-硬联合麻醉用于膝关节镜手术

Small-dose and low-concentration Ropivacaine for combined spinal-epidural anesthesia in knee arthroscopy

目的观察小剂量、低浓度罗哌卡因腰-硬联合麻醉用于膝关节镜手术的安全性、有效性及其优越性。方法择期在腰-硬联合麻醉下行单侧膝关节镜手术患者60例,ASAⅠ或Ⅱ级,分成小剂量组(R25组,试验组)和常规剂量组(R50组,对照组),两组分别给予0.25%和0.5%罗哌卡因3 ml行蛛网膜下腔阻滞,术中视腰麻消退情况硬膜外给予0.25%罗哌卡因维持麻醉效果,每次追加量为5 ml,观察两组术中血流动力学变化、感觉与运动阻滞程度、术后首次排尿时间及不良反应发生情况。结果与常规剂量组相比,小剂量组术中血流动力学稳定、术后感觉与运动功能恢复快、术后首次排尿时间明显缩短、发生不良反应少。结论小剂量、低浓度罗哌卡因腰-硬联合麻醉可安全、有效地应用于膝关节镜手术,且具有一定的优越性。

Objective To analyze the safety, efficiency and superiority of small-dose and low-concentration Ropivacaine for combined spinal-epidural anesthesia in knee arthroscopy. Methods Sixty patients with ASA Ⅰ or Ⅱ undergoing knee arthroscopy were randomized into two groups. Small-dose （ R25 ） group received spinal anesthesia with 0.25% Ropivacaine, while normal-dose （Rs0） group received 0.5 % Ropivacaine. Block effects, hemodynamic changes and first urinating time after operation, as well as side effects in 48 hours were observed. Results In contrast with the normal-dose group, the small-dose group had steadier hemodynamics, faster recovery from blocking, earlier first urinating time after operation, and fewer side effects. Conclusion Small-dose and low concentration Ropivacaine for combined spinal-epidural anesthesia has more safety and more advantage to knee arthroscopy.