罗吡卡因和布吡卡因用于颈丛神经阻滞的效果观察

Comparison of ropivacaine with bupivacaine used for cervical plexus nerve blockade

目的:比较等浓度剂量罗吡卡因和布吡卡因应用于颈丛阻滞的临床效果。方法:40例择期行甲状腺腺瘤手术的病人,随机分为罗吡组和布吡组,每组20例。分别以0.375%罗吡卡因或0.375%布吡卡因行双侧颈浅丛阻滞(每侧各10ml),记录感觉阻滞起效时间、VAS评分、术后痛觉恢复时间、并发症以及神经阻滞前和阻滞后5、10、20和30分钟的MAP、HR和SpO2值。结果:罗吡卡因组感觉阻滞起效时间明显短于布吡卡因组(P<0.01),VAS评分两组无明显差别,而术后镇痛时间明显短于布吡卡因(P<0.01),两组麻醉后均发生心率、血压增高,但组间比较无统计学差异,两组均无严重并发症发生。结论:罗吡卡因能较安全地用于颈丛阻滞,与布吡卡因相比具有起效时间更快、毒性小、同等镇痛效果的特点。

Objective To compare the clinically effect of r opivacaine with equal consistency a nd dosage bupiva-caine in cervical plexus blockade.Methods Forty patients scheduled for electi ve thyroid adenoma surgery were divided into two groups and received bilateral cervical plexus blockade with 0.375%ropivacaine or 0.375%bupivacaine respectively.Sensory block onset t ime,VAS score ,the first pain time after surgery and complication were re corded.Blood pressure ,heart rate,and puls e oxygen saturation were monitored b efore anesthesia and at 5?10?20and 30min after anesthesia.Results The sensory onset time and postopera tive analgesia time were significan tly shorter in ropiva-caine group than those in bupivacain e group;VAS score was not significan tly different between the two groups.Blood pressure and heart rate were all sign ificantly increased after anesthesia in both groups.There was no seriou s compli-cation in two groups.Conclusions Compared with bupivacaine,ropivacaine has advantage of lower toxicity,quicker onset time,equal analgesic effect .Ropivacaine can be safely used for cervical plexus blockade.