布比卡因与左布比卡因在婴幼儿骶管麻醉中的临床效果比较

The effect of bupivacaine and levobupivacaine for caudal anesthesia in infant and children

目的 比较布比卡因和左布比卡因在婴幼儿骶管麻醉中的临床效果.方法 选择40例3～6岁、ASA Ⅰ级、择期行腹股沟疝修补术的婴幼儿,按照随机数字表法分为布比卡因组和左布比卡因组,每组20例,分别使用相同剂量和浓度的布比卡因和左布比卡因行骶管麻醉.术中监测血压、心率和脉搏血氧饱和度,术后评估两组患者的疼痛和运动阻滞程度.结果 布比卡因和左布比卡因在婴幼儿骶管麻醉中均可提供良好的镇痛效果.两组术后疼痛评分比较差异无统计学意义（P＞0.05）.在术后60、90、120 min,布比卡因组运动阻滞评分高于左布比卡因组[（1.5±0.6）分比（0.9±0.3）分、（1.0±0.8）分比（0.1±0.5）分、（0.6±0.5）分比（0.0±0.7）分],差异有统计学意义（P＜0.05）.结论 布比卡因与左布比卡因在骶管麻醉中镇痛效应相似;在运动阻滞方面,左布比卡因优于布比卡因.

Objective To compare the effect of bupivacaine and levobupivacaine for caudal anesthesia in infant and children.Methods Forty patients with age 3-6 years old in the state of ASA Ⅰ grade were randomly divided into bupivacaine group and levobupivacaine group,each 20 patients.Both groups received respectively bupivacaine or levobupivacine with the same concentration and volume.The blood pressure,heart rate and pulse oxygen saturation were monitored during the operation.The degree of pain and motor was assessed after the operation.Results Bupivacaine and levobupivacaine for caudal anesthesia in infant and children could provide good analgesic effects.The scores of pain was similar between the two groups and had no statistic significance （P ＞ 0.05）.The scores of motor block in bupivacaine group was significantly higher than that in levobupivacaine group after anesthesia 60,90,120 min [（1.5 ±0.6） scores vs.（0.9 ±0.3） scores,（1.0 ±0.8） scores vs.（0.1 ±0.5） scores,（0.6 ±0.5） scores vs.（0.0 ±0.7）scores],there was significant difference （P ＜ 0.05）.Conclusions Bupivacaine and levobupivacaine have the same analgesic potency.Levobupivacaine is better than bupivacaine in motor block.