罗哌卡因与布比卡因用于硬膜外阻滞的临床对比观察

Clinical Observation on Peridural Block Anesthesia by Narcoties Ropivacaine and Bupivacaine

目的 :将新型酰胺类局麻药罗哌卡因药效学与布比卡因进行比较。方法 :选择行择期下肢手术病人 4 0例 ,随机分成四组进行硬膜外麻醉 ,分别在硬膜外注入 0 75 %罗哌卡因 ( n=1 0例 ) ,0 5 %罗哌卡因 ( n=1 0例 )和 0 75 %布比卡因(n =1 0例 ) ,0 5 %布比卡因 (n =1 0例 ) 1 5～ 1 8ml。分别观察感觉阻滞起效 ,最大运动阻滞 ,感觉、运动恢复时间及最高阻滞平面 ,最大Bromage评分及术中不良反应的情况。结果 :罗哌卡因起效快 ,产生的麻醉平面广 ,镇痛、运动阻滞效果好。术中有低血压、心率减慢等副作用发生。结论 :罗哌卡因应用于临床麻醉有可靠的麻醉性能及安全性 ,利用其感觉运动神经分离作用 ,利于病人术后早期活动 ,具有良好的临床应用前景。

Objective:To compare the narcotic potency between ropivacaine and bupivacaine.Methods:Forty patients chosen for undergoing legs surgery were randomly divided into four groups and operated on as scheduled under epidural block anesthesia with various dosages based on body weight:group Ⅰ (n=10) and groupⅡ(n=10)were injected 0.75% and 0.5% ropivacaine 15～18ml,and group Ⅲ(n=10) and group Ⅳ(n=10) injected 0.75% and 0.5% bupivacaine 15～18ml respectively.The moment by then the sensory nerve block and the maximal motor nerve block began and the sensory and motor nerve recovered was recorded individually and separately.The plane of maximal block anesthesia,the maximal Bromage mark and adverse reactions during operation were also carefully observed for comparison.Results:The block onset of narcotic ropivacaine showed to be quicker,the block plane to be wider and the efficacy of analgesia and the kinetic block to be better than that of bupivacaine.The side effects,such as hypotension,reduced heart rate etc also happened occasionally during operation.Conclusion:Narcotic ropivacaine is of the advautages:reliable anesthetic nature and safety,the action of sensorimotor nerve block dissociation which makes patients take active motion earier after operation,and therefore possesses favourable prospects for clinic use.