罗哌卡因对腰硬联合麻醉下子宫全切术患者运动神经阻滞的影响

Influence of ropivacaine on motor nerve block in patients with total hysterectomy under combined spinal epidural anesthesia

目的研究罗哌卡因对腰硬联合麻醉下子宫全切术患者运动神经阻滞的影响。方法收集2014年1月至2015年12月内蒙古自治区妇幼保健医院子宫肿瘤患者108例,将患者随机分为罗哌卡因组和左旋布比卡因组。主要观察指标为术中平均动脉压(MAP)、感觉神经阻滞时间、运动神经阻滞时间和Bromege评分。结果与左旋布比卡因组相比,罗哌卡因组患者运动神经阻滞时间显著缩短[(154.83±35.12)min vs.(190.24±33.06)min,P<0.001],Bromege评分显著降低[(2.46±1.06)分vs.(2.89±0.79)分,P=0.02]。两组患者术中各个时间点的MAP、感觉神经阻滞时间、恶心、呕吐和头痛等并发症差异无统计学意义(P>0.05)。结论与左旋布比卡因相比,罗哌卡因在腰硬联合麻醉下子宫全切术中是安全有效的,显著降低了患者运动神经阻滞时间。

Objective To investigate the influence of ropivacaine on motor nerve block in the patients with total hysterectomy under combined spinal epidural anesthesia .Methods A total of 108 patients with total hysterectomy in the Maternal and Child Health Care Hospital of Inner Mongolia Autonomous Region from Jan .2014 to Dec .2015 were collected and randomly divided into the ropivacaine group and levobupivacaine group .The main observation indicators included mean arterial pressure （MAP） ,sensory nerve block duration ,motor nerve block duration and Bromege score .Results Compared with the levobupivacaine group ,the motor nerve block duration in the ropivacaine group was significantly shortened[（154 .83 ＆#177; 35 .12） min vs .（190 .24 ＆#177; 33 .06）min ,P〈0 .001];the Bromege score was significantly decreased[（2 .46 ＆#177; 1 .06） points vs .（2 .89 ＆#177; 0 .79） points ,P=0 .02] .MAP ,sensory nerve block duration and complications of nausea ,vomiting and headache had no statistical differences between the two groups（P〉0 .05） .Conclusion Compared with levobupivacaine ,ropivacaine is safe and effective in total hysterectomy under combined spinal epidural anesthesia and significantly reduces the motor nerve block duration .