罗哌卡因复合曲马多的硬膜外麻醉效果

Clinical anesthetic effects of epidural ropivacaine with tramadol

目的 :观察硬膜外罗哌卡因复合曲马多在下肢手术的麻醉效果。方法 :30例ASAⅠ～Ⅱ级下肢手术患者随机分为二组 :罗哌卡因组 (R组 ,n =1 5 )和罗哌卡因复合曲马多组 (T组 ,n =1 5 )。硬膜外穿刺部位均为L2 3 间隙 ,每组硬膜外首剂量均为 2 %利多卡因 3ml(试验量 ) +0 .75 %罗哌卡因 1 0ml,R组复合生理盐水 1ml,T组复合曲马多 5 0mg(1ml)。于单次剂量麻醉期间对镇痛效果、运动阻滞及镇静程度予以分级评定 ,记录感觉阻滞达T1 2 ,T1 0 及最高平面时间、镇痛持续时间和不良反应及辅助用药情况。结果 :T组感觉阻滞达T1 2 ,T1 0 及最高平面时间缩短 ,镇痛持续时间延长 (P <0 .0 5 ) ,镇痛效果、运动阻滞情况和镇静程度二组无差异 (P >0 .0 5 ) ,未见明显不良反应。结论 :罗哌卡因复合小剂量曲马多可以增强罗哌卡因的硬膜外麻醉效果。

Objective To observe the anesthesic effects of epidural ropivacaine with tramadol during lower limbs surgery. Methods Thirty patients (ASAⅠ～Ⅱ) scheduled for the lower limbs surgery were randomly divided into 2 groups with 15 patients in each group: group ropivacaine (R) and group ropivacaine with tramadol (T).The puncture was performed at the interspace of L 2 3 .Each patient was given 2% lidocaine 3 ml with 0.75% ropivacaine 10 ml which included NS 1ml in Group R or tramadol 50 mg in Group T.The potency of analgesia, the time of sensation block to T 12 and T 10 , the time to the highest plane of analgesia ,the lasting time of analgesia,the degree of sedation, the degree of motor block,and the side effects were recorded and analyzed during anesthesia after the first dose.Results The time of sensation block which reached T 12 and T 10 ,and the time to the highest plane of analgesia decreased significantly in Group T than that in Group R ( P <0.05) .The lasting time of analgesia in Group T was longer than that in Group R ( P <0.05).There was no significant difference in the potency of analgesia, the degree of sedation and motor block,and the side effects ( P >0.05).Conclusion The epidural ropivacaine with tramadol enhanced the anesthetic effects of ropivacaine.