探讨不同海拔下罗哌卡因剂量在大隐静脉曲张术中的运用

Research the Dose of Ropivacaine on High Ligation of GSV Combined with PFS at Different Altitudes

目的探讨不同海拔下罗哌卡因剂量在大隐静脉曲张术中的运用。方法分别选取昌都市(高海拔)和天津市(低海拔)两地医院拟行蛛网膜下隙阻滞罗哌卡因麻醉的大隐静脉曲张患者160例,分为高海拔组(H组)和低海拔组(L组),每组各80例。并按罗哌卡因麻醉剂量不同,H组(AH、BH、CH、DH)四小组及L组(AL、BL、CL、DL)四小组,每小组20例。观察每小组的感觉运动阻滞及麻醉并发症情况。结果运动阻滞起效时间、感觉阻滞恢复时间和运动阻滞恢复时间:AH组、BH组、CH组、DH组高于AL组、BL组、CL组、DL组,各组间差异存在统计学意义(P<0.05);Bromage评分DL组高于AH组,两间差异存在统计学意义(P<0.01);出现并发症:AH组心率高于DL组,DH组高于尿潴留DL组,各组间差异存在统计学意义(P<0.01)。结论罗哌卡因麻醉药物计量,高海拔地区比低海拔明显减少。

Objective: To investigate the dose of ropivacaine on high ligation of GSV combined with PFS at different altitudes. Methods:Totally, 160 patients with saphenous vein varicosity undergoing high ligation of GSV combined with PFS, who were treated with arachnoidea u nder block anesthesia. They were randomly divided into L group(patients living in Tianjin) and H group(patients living in Qamdo). According to the dose of ropivacaine, Patients in L group was divided into group AL(n=20), group BL(n=20), group CL(n=20), group DL(n=20),while patients in H group was divided into group AH(n=20), group BH(n=20), group CH(n=20), group DH(n=20). The anesthetic effect and anesthesia complication were compared. Results: The onset time of sensory block and motor block in groups of AH, BH, CH, DH were significantly better than those in groups of AL, BL, CL, DL. The recovery time of motor nerve block in groups of AH, BH, CH, DH was significantly better than those in groups of AL, BL, CL, DL(P< 0.05).(2) The scores of Bromage in group DL was significantly higher than that in group AH(P<0.01).(3) The heart rate in group AH were significantly higher than that in group DL. The postoperative uroschesis in group DL was significantly higher than that in group DL(P<0.01). Conclusions: The dose of ropivacaine at low altitudeis is obviously decreased.