摘要
目的探讨0.75%罗哌卡因用于小儿蛛网膜下腔阻滞的合适剂量。方法选择ASAI-Ⅱ级择期手术的小儿患者60例,随机分为三组,每组20例。A组0.75%罗哌卡因2ml(按每厘米椎管长0.15mg给药)、B组0.75%罗哌卡因2ml(按每厘米椎管长0.3mg给药)、C组0.5%布比卡因2ml(按每厘米椎管长0.15mg给药)。用药后观察最高感觉阻滞平面等蛛网膜下腔阻滞运动和感觉参数、监测不同时间段的MAP、HR值和不良反应和并发症。结果A组最高阻滞平面、T10感觉平面阻滞持续时间、平面固定时间、运动起效时间、运动恢复时间,与C组比较,差异有统计学意义(F分别=0.16、7.03、0.57、19.23、1.17,P均<0.05),与B组比较,差异有统计学意义(F分别=0.21、6.78、0.78、17.98、1.23,P均<0.05);A组下肢运动阻滞程度弱于C组,差异有统计学意义(χ2分别=40.83、21.16、10.42,P均<0.05),与B组比较,差异有统计学意义(χ2分别=36.01、21.16、9.60,P均<0.05);B组运动恢复快于C组,差异有统计学意义(F=1.23,P<0.05);B组感觉阻滞起效时间与A组、C组比较,差异无统计学意义(F分别=4.13、4.54,P均>0.05)。结论0.75%罗哌卡因每厘米椎长0.3mg用于小儿脊麻能达到安全麻醉;而0.75%罗哌卡因每厘米椎长0.15mg用于小儿脊麻,运动、感觉阻滞较布比卡因差。
Objective To observe the effects of different doses of ropivacaine for spinal anesthesia, and compare with bupivacaine. Methods Sixty ASAⅠ- Ⅱ children, scheduled for low abdominal surgery and lower limb operations were randomly allocated to three groups ,group A was received 0.75% ropivacaine 0.15mg/spinal length, group B was received 0.75% ropivacaine 0.3mg/spinal length, group C was received 0.5% bupivacaine 0.15mg/ spinal length. The onset time and duration,the upper level of anesthesia, degree of motor block were recorded , the vital signs of the kids were recorded during the surgery. Results There were statistic differences in the upper level of anesthesia , duration time of T10 sensory block, the fixed time of sensory block, onset time of motor block and the motor recuperation time between group A and group C （F = 0.16,7.03,0.57,19.23,1.17 , P〈 0.05）, and group B （F =0.21,6.78,0.78,17.98,1.23, P〈0.05）. The degree of the motor block of group A was weaker than group C（X^2= 40.83,21.16,10.42, P〈0.05）, and group B（X^2= 36.01,21.16,9.60,P〈0.05）. The motor recuperation time of group B was faster than group C （F=1.23,P〈0.05）. There were no differences in onset time of sensory block between group B and the other 2 groups （F= 4.13,4.54, P〉0.05,）.Conclusions 0.3mg/spinal length 0.75% ropivacaine is safe anesthesia for children; 0.15mg/spinal length ropivacaine is a weaker motor block and sensory block than bupivacaine.
出处
《全科医学临床与教育》
2008年第3期198-200,203,共4页
Clinical Education of General Practice
