罗哌卡因与布比卡因用于小儿硬膜外麻醉的临床研究

Clinical study of using ropivacaine and bupivacaine for spinal anesthesia in children

目的 :分析比较罗哌卡因 (新型酰胺类局部麻醉药 )与布比卡因在小儿临床手术中产生的麻醉效能。方法 :选择择期行下腹部、下肢、肛门手术的小儿 5 0例 ,随机分成两组 ,每组各 2 5例。对 5 0例小儿均行硬膜外穿刺 ,在硬膜外分别注入 0 .5 %罗哌卡因或 0 .35 %的布比卡因。分别在第一时间、第二时间、第三时间、第四时间监察麻醉平面和肌松程度及术中镇痛效果 ,同时监测并记录小儿的血压、心律、血氧饱和度及不良反应 ,并检测 T3、T4 和皮质醇的变化。 结果:罗哌卡因产生的麻醉平面较广 ,镇痛和肌松效果好 ,运动阻滞效果好 ,能显著降低收缩压和舒张压 ,但作用消失快 ,而布比卡因仅能降低舒张压。罗哌卡因和布比卡因组 T3、T4 及皮质醇的变化无统计学意义。 结论 :0 .5 %罗哌卡因可较安全地应用于小儿低位硬膜外麻醉 ,能取得良好的镇痛和肌松效果 。

Objective: To compare the anesthesia efficiency of a new kind of ameds local anesthesia drugs ropivacaine and bupivacaine in the course of operation. Methods: To choose the operation of lower abdomen, lower limbs and rectum in 50 child patients, age ranging from 3 to 13, separated to two groups, each was 25 patients. All of the patients were received spinal anesthesia. using 0.5% ropivacaine and 0.35% bupivacaine. It was arranged to 4 times to invastigate the plane of anesthesia, the degree of muscle relaxation and the efficiency of pain relief in operation at the same time. To investigete the blood pressure, heart rate, SaO\-2, and bad effect. To investigate T\-3, T\-4 and steroid. Results: Ropivacaine could produce wide plane of anesthesia; the efficiency of muscle relaxation, pain relief, nerve blockage was good and the disappearing time was short. It could lower systolic blood pressure and diastolic pressure; there was no difference of T\-3, T\-4 and steroid between the two groups. Conclusion: If 0.5% ropivacaine are used for spinal anesthesia in children, it can produce good efficiency of pain relief, it has good clinical prospects.