摘要
目的比较氯普鲁卡因与利多卡因用于硬膜外阻滞的效果。 方法将 40例拟在硬膜外麻醉下施行下腹部、盆腔部择期手术的妇产科患者 ,随机分入氯普鲁卡因组和利多卡因组各 2 0例。行硬膜外穿刺置管 ,分别注入 2 %氯普鲁卡因 5ml或 2 %利多卡因 5ml。 5min后 ,如无全脊麻现象 ,再予 2 %氯普鲁卡因或 2 %利多卡因 10ml,观察心率、血压、呼吸次数和氧饱和度及阻滞起效时间、痛觉消失与持续时间、硬膜外阻滞范围。 结果利多卡因组麻醉起效时间为 4.13±1.5 1min ,痛觉消失时间为 10 .2 7± 2 .31min。氯普鲁卡因组分别为 2 .0 0± 0 .6 5min和 7.76± 1.95min( P均 <0 .0 1) ,麻醉持续时间 :利多卡因组为 47.2 7± 11.82min ,氯普鲁卡因组为 5 2 .0 0± 8.40min(P <0 .0 5 )。两组阻滞范围相同。用药后10、30、6 0min ,利多卡因组收缩压均显著低于用药前 (P <0 .0 1) ,氯普鲁卡因组仅在用药后 10min低于用药前水平 (P <0 .0 5 )。 结论氯普鲁卡因用于妇产科硬膜外阻滞麻醉较利多卡因起效快 ,痛觉完全消失快。在阻滞范围和持续时间上二者无显著差异。
Objective To compare the efficacy of chlorprocaine hydrochloride with lidocaine in epidural blockage. Methods Forty patients undergoing elective obstetrictal and gynecological surgery (age 20 ～60, ASA Ⅰ ～ Ⅱ) were randomly divided to 2 groups, chlorprocaine group (test group), lidocaine group (n=20) as control group. All patients were given either 2% chlorprocaine hydrochloride or 2% lidocaine according to their group. After a 5ml test dose injected into epidural space (L 2-3 or L 3-4), a bolus of another 10ml local anesthetic was given. The vital signs (HR, BP, RR, SpO 2) and the efficacy of each drug (onset time of pain free, duration time, and blockage level) were recorded. Results In the lidocaine group, the onset time of blocking was (4.15±1.51)min and the onset time of pain free is (10.27±2.31)min, while in the chlorprocaine group they were (2.00±0.65)min and (7.67±1.95)min, respectively (P<0.01). Blocking duration was (47.27±11.82)min in the lidocaine group and (52.00±8.40)min (P>0.01) in chlorprocaine group. At 10,30,60 min post-anesthesia, systolic pressure in test group were significantly lower than that of pre-anesthesia (P<0.01), while in control group only 10min post-anesthesia systolic pressure was lower than that of pre-anesthesia (P<0.05). Conclusion Chlorprocaine hydrochloride has shorter onset time and pain free in epidural anesthesia time for obstetrical and gynercological and has no difference in anesthetic blockage level and duration time. Chlorprocaine hydrochloric is a good choice for epidural anesthesia in obstetrics and gynecology.
出处
《上海第二医科大学学报》
CSCD
2002年第4期343-344,347,共3页
Acta Universitatis Medicinalis Secondae Shanghai
