罗哌卡因对胸段硬膜外麻醉患者心率变异及肺功能的影响

目的探讨罗哌卡因对胸段硬膜外麻醉患者心率变异及肺功能的影响。方法选择我院胸段硬膜外麻醉下行手术治疗的82例患者,按照随机分层分组法将所有患者分为观察组和对照组,对照组硬膜外麻醉给予利多卡因,观察组硬膜外麻醉给予罗哌卡因,观察两组不同时间段心率变异性(HRV)和肺功能。结果两组阻滞后5、15 min较阻滞前心率(HR)、收缩压(SBP)、舒张压(DBP)及HRV均有所下降(均P0.05),两组阻滞后15min较阻滞前肺活量(VC)、第1s用力肺活量(FVC1)、潮气量(VT)及最大通气量(MMV)显著下降(均P0.05)。对照组阻滞后5、15 min的HRV、HR、SBP及DBP与观察组比较有所下降(均P0.05),而两组肺功能各项指标无显著差异(均P0.05)。结论罗哌卡因应用于胸段硬膜外麻醉对于感觉神经阻滞良好,对患者HRV及肺功能影响较小,有较好的临床应用价值。

Effect of ropivacaine on heart rate variability and pulmonary function during thoracic epidural anesthesia

Objective To explore the effect of ropivacaine on pulmonary function and heart rate variability during thoracic epidural anesthesia. Methods 82 patients were randomly divided into two groups. The control group was given lidocaine, and the observation group was given ropivacaine. Their lung function and heart rate variability were observed. Results Their HR, SBP, DBP and HRV 5, 15min after anesthesia decreased significantly after anesthesia （all P〈0.05）, and the decrease was more pronounced in the observation group than in the control group （all P〈0.05）. There was no significant difference in lung function between the two groups （all P〉0.05）. Conclusion Ropivacaine may give a satisfactory interference on sensational nerve during thoracic epidural anesthesia, and it has a small effect on pulmonary function and HRV.