不同麻醉药物在髋关节置换术临床应用中的对比研究

Comparisons of Different Local Anesthetics for Hipbone Replacement

目的比较罗哌卡因、左旋布比卡因和氯普鲁卡因在髋关节置换中的应用效果。方法将86例髋关节置换术患者根据随机数字法分为三组:左旋布比卡因组(A组)、罗哌卡因组(B组)和氯普鲁卡因组(C组)。记录患者感觉阻滞起效时间、平面固定时间、阻滞平面、腰麻持续时间和运动阻滞效果。结果三组患者的麻醉持续时间比较差异有统计学意义(P<0.01);C组最高阻滞平面显著高于A组和B组(P<0.01);B组的改良Bromage评级显著高于A组和C组(P<0.05)。结论与左旋布比卡因和氯普鲁卡因比较,罗哌卡因腰硬联合麻醉具有感觉阻滞完善、运动阻滞效果弱、并发症少等优点,最适合于髋关节置换术的麻醉。

Objective To compare the effect of chlorprocaine with levobupivacaine or ropivacaine in combined spinal epidural anesthesia for hipbone replacement.Methods Eighty-six patients with hipbone replacement were randomly divided into three groups： ropivacaine group（group A）,levobupivacaine group（group B） and chloroprocaine group（group C）.The onset time of sensory block,time for fixed block level,sensory block level,duration of spinal block as well as the effect of motor block was recorded.Results The duration of spinal block was significantly different from each other（P 0.01）;the maximum block plane of group C was significantly higher than group A and group B（P 0.01）.The modified Bromage scores of group B were significantly higher than group A and group C（P 0.05）.Conclusion Compared with levobupivacaine and chloroprocaine,ropivacaine may be more suitable for hipbone replacement for its features of satisfactory sensory block,weak motor block and fewer complications in combined spinal epidural anesthesia.