罗哌卡因与布比卡因腰麻在肛肠疾病术中应用比较

观察比较小剂量相同浓度罗哌卡因与布比卡因腰麻在肛肠疾病手术中的麻醉效果。将80例ASAI，Ⅱ级肛门直肠部择期手术患者按双盲法随机分为罗哌卡因组和布比卡因组，每组40例。两组腰麻用药分别为0．5％罗哌卡因和0．5％布比卡因，用量均为1．5ml。记录两组感觉阻滞、运动阻滞情况和麻醉各时点血压心率变化及不良反应。结果显示，两组均获得满意的麻醉效果。罗哌卡因组和布比卡因组的运动阻滞起效时间分别为（182．5±26．8）s和（145．7±27．4）S（P〈0．01），最大运动阻滞时间分别为（12．7±4．2）min和（8．0±3．5）min（P〈0．05），运动阻滞恢复时间分别为（125．9±32．5）min和（158．8±38．7）min（P〈0．01），感觉阻滞起效时间、程度、阻滞平面相似，两组均无严重不良反应发生。结果表明，0．5％罗哌卡因腰麻用于肛肠疾病手术，能达到满意的麻醉效果，且安全、运动阻滞程度轻。

Comparison of the Anesthetic Efficacy of Ropivacaine and Bupivacaine Applied in Lumbar Anesthesia during Surgical Operations of Anorectal Diseases

The objective of this study is to compare the anesthetic efficacy of same concentration of lowdose ropivacaine and bupivacaine applied in lumar anesthesia duning surgical operations of anorectal disease. Eighty patients with anorectal diseases（stage Ⅰ or Ⅱ ） to be operated on were randomised into ropivacaine group（ n = 40） and bupivacaine group（ n =40）. The volume applied in lumbar anesthesia in ropivacaine group was 1.5ml（0.5% ropivacaine） ,while that in bupivacaine group was also 1.5ml （0.5% bupivacaine）. The sensory block, exercise block, blood pressure and heart beat at different time interval, and adverse reations in the two groups were recorded. As results, the starting time of exercise block in ropivacaine group and bupivacaine group was （182.5±26.8） seconds and （145.7±27.4）seconds（ P 〈0.01） respectively,the maximum exercise block time was （12.7±4.2）minutes and （8.0~3.5）minutes （ P 〈0.05） in the two groups respectively,the exercise block recovery time in the two groups was （125.9±32.5）minutes and （158.8±38.7）minutes（ P 〈0.01） respectively. There was similiar in the starting time,degree,plane of sensory block between two groups and no notable adverse reactions in the two groups. It is concluded that ropivacaine applied in lumber anesthesia can reach a safe and satisfying anesthetic efficacy during anorectal operations.