摘要
目的 比较研究不同浓度的罗哌卡因在下肢手术中的麻醉效果。方法 选择 2 6例下肢手术的病人 ,随机分成两组 ,Ⅰ组 0 .75 %罗哌卡因组 ,Ⅱ组 0 5 %罗哌卡因组 ,每组各 13例。所有病人均选择L1～ 2 、L2～ 3 间隙穿刺 ,向头端置管。麻醉诱导后观察不同起效时间 ,阻滞完善时间 ,以及手术开始前趾、踝关节、膝关节、髋关节以及下肢抬举的运动情况并予以记录。同时监测记录SBP、DBP、HR。对所有结果进行统计学分析。结果 两组间SBP、DBP、HR差异无显著性 (P >0 .0 5 ) ,两组病人间的起效时间、趾动和下肢抬举差异无显著性 (P >0 .0 5 )。两组间阻滞完善的时间、踝关节、膝关节、髋关节运动差异有显著性 (P <0 .0 5 )。Ⅰ组诱导后的 15、2 0、2 5、30minSBP、DBP与基础比较差异有显著性 (P <0 .0 5 ) ,HR和基础比较差异无显著性。Ⅱ组诱导后的 2 0、2 5、30minSBP、DBP与基础比较差异有显著性 (P <0 .0 5 ) ,HR和基础比较差异无显著性。结论 在下肢手术时 ,要求保留运动功能 ;需要维持稳定的血流动力学时 ;最好选用 0 .5 %罗哌卡因 ,不要求保留运动功能 ;急诊手术时 ;可以选用 0 .75 %罗哌卡因。对心脏毒性方面 。
AIM To compare anesthetic effect of ropivacaine on different concentration in lower extremity surgery. METHODS The patients, who was undergoing lower extremity surgery,have been divided into two groups: group Ⅰ(0.75% ropivacaine, n=13),grou2pⅡ(0.5%ropivacaine , n =13).All of patients have been given epidural acupuncture at L 1～2 or L 2～3 point ,then one catheter was inserted cephalad. After induction, anesthetic initial time,time to block soundly and condition on moving of dactylus and lower limb,moving of articulus of coax,geniculum and malleolus have been recorded. In addition, SBP,DBP and HR have been monitored during anesthesia. RESULTS There are no significant different in SBP,DBP,HR,anesthetic initial time, condition on moving of dactylus and lower limb during anesthesia ( P >0.05). In group Ⅰ,compare with basal values, SBP and DBP after induction15,20,25,30 min have significant different respectively ( P <0.05).On the other hand ,there are significant different between SBP and DBP basal values and after induction 20, 25 and 30 min in group Ⅱ( P <0.05).CONCLUSION If both preserving lower limb moving function and keeping hemodynamic stable were asked, 0.5%ropivacaine will be suggested. However, if moving function is not needed or is an emergency operation, 0.75%ropivacaine is a good selection. both concentration anesthetics have less cardiac toxicity.
出处
《安徽医药》
CAS
2003年第3期170-171,共2页
Anhui Medical and Pharmaceutical Journal
