摘要
目的对比研究罗哌卡因联合利多卡因与利多卡因与布比卡因混合液在眼后节手术中的应用。方法选择100例择期行玻璃体视网膜手术的患者,随机分成2组:10g.L-1罗哌卡因联合20g.L-1利多卡因组(罗哌利多组)50例,20g.L-1利多卡因联合7.5g.L-1布比卡因以1:1混合组(利多布比组)50例,由同一位手术医师对手术患者施行麻醉。罗哌利多组行罗哌卡因球后麻醉4mL,利多卡因筛前麻醉2mL;利多布比组行利多卡因与布比卡因混合液球后麻醉4mL及筛前麻醉2mL,在注射麻醉药后5min、10min、15min评估患者感觉和运动阻滞情况,术后1h、3h、6h评估患者运动阻滞程度,术后1h、3h、6h、24h评定患者的疼痛情况。结果2组患者的感觉和运动阻滞起效时间:利多布比组为(3±1)min和(8±5)min,罗哌利多组感觉阻滞起效时间为(4±2)min,但罗哌卡因组47例患者没有明显的运动阻滞(感觉阻滞P=0.250,运动阻滞P<0.001)。术后不同时间没有疼痛患者例数罗哌卡因组全部多于利多布比组,其中罗哌卡因组术后24h45例(90%),利多布比组术后24h18例(36%),2组比较差异有显著统计学意义(P<0.001)。结论罗哌卡因联合利多卡因在眼后节手术麻醉中应用是安全有效、患者更舒适的麻醉方法。
Objective To investigate and compare the application of ropivacaine combined with lidocaine and lidocaine combined with bupivacaine mixture in ocular deutomerite surgery.Methods A total of 100 cases,who were taking vitreoretinal surgery,were randomly divided into two groups,10 g·L^-1 ropivacaine combined with 20 g·L^-1 lidocaine group （ropiva-lidocaine group） and geometric proportion of 20 g·L^-1 lidocaine combined with 7.5 g·L^-1 bupivacaine group （lido-bupivacaine group）,50 cases in each group.All patients were taken anesthesia by the same doctor.Patients were taken anesthesia with 4 mL ropivacaine behind the eyeball and with 2 mL lidocaine before the sieve in ropiva-lidocaine group;Patients were taken anesthesia with 4 mL lidocaine combined with bupivacaine mixture behind the eyeball and 2 mL before the sieve in lido-bupivacaine group.Sensation and motor block situation were evaluated in patients of both two groups after anesthesia for 5 minutes,10 minutes and 15 minutes,respectively.Motor block degrees were evaluated at postoperative 1 hour,3 hours and 6 hours,respectively.Pain conditions of patients were evaluated at postoperative 1 hour,3 hours,6 hours and 24 hours,respectively.Results Sensation was achieved at （3±1）minutes in lido-bupivacaine group and （4±2）minutes in ropiva-lidocaine group（P=0.250）;Motor block was achieved at （8±5）minutes in lido-bupivacaine group,and not obvious in 47 cases of ropiva-lidocaine group（P〈0.001）.Patients with analgesia were more in ropiva-lidocaine group than those in lido-bupivacaine group at postoperative different times,and there were 45 cases（90%） in ropiva-lidocaine group and 18 cases（36%） in lido-bupivacaine group at postoperative 24 hours（P〈0.001）.Conclusion For patients,ropivacaine combined with lidocaine is a safe,effective and comfortable method for anesthesia in ocular deutomerite surgery.
出处
《眼科新进展》
CAS
北大核心
2010年第3期268-270,共3页
Recent Advances in Ophthalmology
关键词
罗哌卡因
利多卡因
布比卡因
麻醉
眼后节手术
ropivacaine
lidocaine
bupivacaine
anesthesia
ocular deutomerite surgery
