布比卡因硬膜外阻滞对凝血功能的影响

Effects of bupivacaine on blood coagulation during epidural anesthesia

目的 研究硬膜外阻滞时布比卡因对血液凝固的影响。方法 4 0例病人随机分成0 75 %布比卡因组 (A组 ,n =2 0 )和 1%利多卡因、0 2 5 %丁卡因复合液组 (B组 ,n =2 0 )。分别于麻醉前 (T1)、用药后 30分钟 (T2 )、用药后 3小时 (T3 )测定激活部分凝血活酶时间 (APTT)、血浆凝血酶原时间 (PT)、凝血酶时间 (TT)、血小板聚集率 (PAgT)。 结果 A组中APTT、PAgT不同时点存在显著差异 (P <0 0 1) ,PT、TT之间无显著差异。B组中APTT、PT、TT、PAgT不同时点之间均无显著差异。结论 布比卡因用于硬膜外阻滞时可显著延长APTT 。

Objective To study the effects of bupivacaine on blood coagulation during epidural anesthesia.Methods 40 ASA physical status Ⅰ and Ⅱ patients were randomly divided into two groups during epidural anesthesia:0 75% bupivacaine group(group A, n= 20),1% lidocaine and 0 25% dicaine compound solution(group B, n= 20).The blood samples were obtained for the measurements of the activated partial thromboplastin time(APTT),plasma prothrombin time(PT),thrombin time(TT),platelet aggregation test(PAgT) at different time points of pre anesthesia(T 1),30min after anesthesia(T 2) and 3 hours after anesthesia(T 3).Results In group A,APTT at T 2 was prolonged significantly compared with that at T 1,T 3.PAgT at T 2 was decreased significantly compared with that at T 1,T 3.In group B,APTT?PT?TT?PAgT were not significantly different among T 1,T 2,T 3.Conclusion Bupivacaine used during epidural blockade can prolong APTT and reduce PAgT. [