5种低浓度罗哌卡因低位硬膜外腔止痛的运动阻滞效应

The motor nerve block effects of different low concentration ropivacaine using low epidural analgesia

目的 研究低浓度罗哌卡因低位硬膜外术后镇痛的合适浓度。方法 选择下肢手术硬膜外麻醉男性患者 6 0例。硬膜外术后止痛与观察于术后 4小时进行 ,随机分 6组 ,双盲法注入“止痛液”8～ 10ml,A、B、C、D、E及F组分别为 :0 1%、0 15 %、0 2 0 %、0 2 5 %、0 30 %罗哌卡因及生理盐水。注药前及注药后 30分钟记录VAS ;阻滞区健侧运动神经反射变化 ;阻滞区的健侧指令运动变化。结果 VAS评分 :A、B、C、D及E组与F组比较均P <0 0 1;阻滞区运动神经反射减弱或消失 ;阻滞区指令运动减弱或消失。结论 0 15 %罗哌卡因是较合适的低位硬膜外止痛浓度。

Objectiae [WT5”BZ]To investigate a suitable concentration of ropivacaine, by which only block pain sensation but not block motions during low epidural analgesia. [WT5”HZ]Methods [WT5”BZ]Sixty patients with epidural anesthesia at legs were select. When four hours after operation, patients were used with double blind method, and were injected 8-10ml of “analgesic' which were 0.1%,0.15%, 0.20%,0.25%,0.30%. ropivacaine and physiology saline at group A,B,C,D,E andF. To observe content before the injection and after 30min of the injection:①visual analogue scale(VAS);②reflex activities (low abdominal reflex, cremasteric reflex, kneejerk reflex, Achilles tendon reflex) and muscular tensions(straight leg raising,knee kicking and pedaling)ofblocked parts after epidural analgesia.[WT5”HZ]Result [WT5”BZ]The epidural anesthesia of 60 cases were satisfactory. After injection of pastoperation analgesia, appeared following changes:In respect of VAS,group A, group B, group C,group D,group E compared with group F,all P<0 01 [WT5”HZ]Conclusion [WT5”BZ]0.15%ropivacaine is the suitable concentration, by which only take place sensory block without motor block.[WT5”HZ]