摘要
目的探讨轻比重罗哌卡因液腰麻-硬膜外联合麻醉(combined spinal/epidural anesthesia,CSEA)在下肢侧卧位手术中的应用效果。方法选择美国麻醉协会体格检查量表Ⅰ～Ⅲ级择期行下肢侧卧位患者60例,按入院先后顺序随机分为L组与H组各30例。L组给予0.5%罗哌卡因轻比重液,H组给予0.5%罗哌卡因重比重液。观察2组感觉、运动阻滞、镇痛效果及不良反应。结果 L组最高阻滞平面和有效镇痛时间明显优于H组,差异有统计学意义(P<0.05);2组感觉阻滞起效时间、达最高阻滞平面时间、运动阻滞起效时间、镇痛评分和Bromage评分,差异无统计学意义(P>0.05);L组不良反应发生率为16.7%(5/30),明显低于H组的26.7%(8/30),差异有统计学意义(P<0.01)。结论轻比重罗哌卡因CSEA镇痛、肌肉松弛效果可靠,无需改变体位,对循环影响小,更为方便、有效、不良反应少,尤其适用于老年患者侧卧位下肢骨科手术。
Objective To study the effect of hypobaric ropivacaine for combined spinal epidural anesthesia （CSEA） in legs- lateral position surgery. Methods Sixty patients with grade Ⅰ -Ⅲ ASA received the combined spinal epidural anesthesia in legs -lateral position and were randomly divided into hypobaric ropivacaine group （L group ） and hyperbaric solution group （H group ） with 30 cases each according to admission order. L group was given 0.5 % hypobaric ropivacaine and H group was given 0. 5% hyperbaric ropivacaine. Feeling, movement block, analgesic effects and adverse reaction of two groups were observed. Results The highest block plane and effective analgesia time in the L group were obviously better than those in the H group （ P 〈 0.05 ）. The onset times of sensory block and movement block, time reaching the highest block plane, visual analog pain scale（VAS） scores and Bromage scores were not significant between the two groups （ P 〉 0.05 ） ; Adverse reaction rate was 16.7% （5/30） in L group and significantly lower than 26.7% （8/30） in the H group （ P 〈 0.01 ）. Conclusion Compared with the CSEA with hyperbaric ropivacaine, the CSEA with hypobaric ropivaeaine is reliable in analgesia and muscle relaxation effect, does not change the position, has little effect on circulation and less adverse reactions, and is more convenient and effective, especially for elderly patients who need legs -lateral position surgery.
出处
《河北医科大学学报》
CAS
2011年第3期300-302,共3页
Journal of Hebei Medical University
关键词
罗哌卡因
麻醉
下肢
ropivacaine
anesthesia
lower extremity
