左旋布比卡因用于蛛网膜下腔阻滞的可行性研究

目的:通过双盲观察小剂量左旋布比卡因用于蛛网膜下腔阻滞的效果,研究其可行性、安全性。方法:400例行下肢或下腹部手术的患者随机分为两组,对照组使用0.75%布比卡因行腰硬联合麻醉(CSEA),试验组使用0.75%左旋布比卡因行腰硬联合麻醉(CSEA),每组200例。药物有效性的观察指标包括:感觉阻滞起效时间、最高感觉阻滞平面、最高感觉平面维持时间、运动阻滞评分。安全性的观察指标包括血压(BP)、心率(HR)、脉搏血氧饱和度(sPO2)、麻醉并发症、术后麻醉恢复时间。结果:两组感觉阻滞起效时间差异无显著性(P>0.05);最高感觉阻滞平面试验组略低于对照组,但差异无显著性;最高感觉平面维持时间试验组略短于对照组,但无显著性差异;两组患者运动阻滞评分差异无显著性;两组各时间段BP、HR、sPO2及麻醉并发症差异无显著性;麻醉恢复时间试验组略短于对照组,但差异无显著性。结论:小剂量左旋布比卡因用于蛛网膜下腔阻滞是安全、可行的。

The Feasibility of Levobupivacaine for Combined Spinal and Epidural Anesthesia

Objective: To evaluate the efficacy and safety of 0.75% levobupivacaine for combined spinal and epidural anesthesia(CSEA).Methods:A total of 400 patients(undergoing selective lower abdominal or lower extremity operations) were randomly divided into two groups(200 in each group):the patients in groupⅠand groupⅡ received 0.75% bupivacane or 0.75% levobupivacaine for combined spinal and epidural anesthesia,respectively.The onset time of sensory block,the plane of maximum sensory block,the maintenance time of maximum sensory block plane and the scores of motor block were observed for the efficacy of anesthesia drugs.BP,HR,sPO2,side effects and the recovery time of anesthesia after operation were monitored or recorded for the safety of anesthesia drugs.Results:There were no significant difference(P>0.05) in the onset time of sensory block,the plane of maximum sensory block,the maintenance time of maximum sensory block plane and the scores of motor block between the two groups.BP,HR,sPO2,side effects and the recovery time of anesthesia after operation were not significantly different between the two groups(P>0.05).Conclusion:0.75% levobupivacaine for combined spinal and epidural anesthesia(CSEA) is safe,effective and feasible for lower abdominal and lower extremity operation.