0.75%罗比卡因与0.75%布比卡因应用于肾移植术的比较

Comparison of 0.75% ropivacaine with 0.75% bupivacaine epidurally used for renal transplantion

目的 比较 0 75 %罗比卡因与 0 75 %布比卡因硬膜外麻醉用于肾移植术的临床效果。方法 肾移植术者 2 4例 ,随机分为R1组和B1组 ,每组 12例。肾功能正常行下腹或下肢手术者 2 0例 ,随机分为R2组和B2组 ,每组 10例。硬膜外分别注入 0 75 %罗比卡因或 0 75 %布比卡因16ml。监测循环改变 ,测定感觉阻滞及下肢运动阻滞效果。结果 R1组运动阻滞达峰时间及麻醉起效时间明显慢于B1组。运动阻滞维持时间R1组短于B1组。最高感觉阻滞平面、感觉阻滞达峰时间及维持时间R1组与B1组相似。B2组运动阻滞达峰时间短于R2组。感觉阻滞达峰时间R1组短于R2组、B1组短于B2组 ,维持时间R1组长于R2组 ,B1组长于B2组。结论 行肾移植术者无论使用罗比卡因还是布比卡因 ,其感觉阻滞达峰快 ,作用维持时间长。 0 75 %罗比卡因与 0 75 %布比卡因相比 ,感觉阻滞起效慢 ,运动阻滞达峰时间慢而维持时间短 。

Objective To compare the clinical efficacy of epidural 0 75% ropivacaine with 0 75% bupivacaine in patients with chronic renal failure(CRF).Methods Twenty four patients underwent renal transplation were randomly divided into two groups:Group R1( n= 12) and Group B1( n= 12).Another twenty patients with normal renal function undergoing lower limb surgery or subabdominal surgery,were selected and randomly divided into two groups:Group R2( n= 10) and Group B2( n= 10).The patients in group R1 and R2 received 0 75% ropivacaine and in group B1 and B2 0 75% bupivacaine.Onset time for sensory block,time for maximum cephaled spread of sensory block,degree of motor block and duration of sensory and motor block were measured in all patients.Results The time to maximal motor block and the onset of sensory block (to T12)were significantly slower in group R1 than those in group B1.Duration of motor block in group R1 was significantly shorter than that in group B1.Peak sensory level and the times to maximal sensory block and duration of sensory block were similar in group R1 and B1.The time to maximal motor block was shorter in group B2 than that in group R2.The time to maximal sensory block in group R1 and B1 was shorter than that in group R2 and B2.Duration of sensory block in group R1 and B1 was longer than that in group R2 and B2.Six Patients in group B1 and three patients in group R1 received supplemental dopamine intravenously.Conclusion Either 0 75% ropivacaine or 0 75% bupivacaine produced a shorter onset and prolonged sensory block in CRF patients than those in normal renal function patients.The hemodynamic changes tend to be more stable in CRF patients received 0 75% ropivacaine than those received 0 75% bupivacaine. [