盐酸罗哌卡因和布比卡因用于腰麻+硬膜外麻醉在妇科手术的临床效果观察

目的:比较盐酸罗哌卡因、布比卡因腰麻+硬膜外麻醉用于妇科手术的临床效果。方法:100例妇科手术病人,随机分成A、B2组,每组50例,A组盐酸罗哌卡因(1%盐酸罗哌卡因1.7ml+麻黄碱0.1ml+50%葡萄糖0.2ml);B组布比卡因(0.75%布比卡因1.7ml+麻黄碱0.1ml+50%葡萄糖0.2ml),行腰麻+硬膜外麻醉,观察感觉阻滞起效时间、运动阻滞起效时间、最高感觉阻滞平面、最大感觉阻滞时间、最大运动阻滞时间、感觉恢复时间、运动恢复时间及麻醉效果与不良反应。结果:A组感觉阻滞起效时间明显慢于B组,运动阻滞起效时间明显慢于B组(P<0.01);2组最高感觉阻滞平面无显著差异(P>0.05);A组最大运动阻滞时间明显慢于B组,运动阻滞恢复时间明显短于B组(P<0.01);2组麻醉效果评定无统计学差异(P>0.05)。A组不良反应的发生率明显小于B组(P<0.01)。结论:盐酸罗哌卡因较之布比卡因用于腰麻+硬膜外麻醉在妇科手术更加安全有效,更有利于患者术后恢复。

Ropivacaine Hydrochloride Bupivacaine for Spinal Anesthesia and Epidural Anesthesia in Gynecologic Surgery + Clinical Efficacy

Objective. To compare ropivaeaine hydroehloride, bupivacaine spinal anesthesia ＋ epidural anesthesia for gynecological surgery, the clinical results. Methods： 100 eases of gynecological surgery patients were randomly divided into A, B group, n= 50, A group of ropivaeaine hydroehloride （1% ropivacaine hydroehloride ephedrine 1.7ml ＋ 0. lml ＋50% glucose 0. 2ml）;B group bupivacaine（0. 75% bupivacaine 1.7ml＋ephedrlne 0. lml＋50% glucose 0. 2ml） ,line of spinal anesthesia＋ epidural anesthesia to observe the onset time of sensory block, motor block onset time, maximum sensory block level, the maximum sensory block time, the maximum time for motor block, sensory recovery time, recovery time and anesthesia movement and adverse reactions. Results： A group of sensory block onset time was slower than the B group,motor block onset time was slower than that in group B（P〈0. 01）;two highest sensory block level was no significant differenee（P〉0. 05） ;A group of maximum motor block was significantly slower than the B group, motor block recovery time was significantly shorter in group B（P〈0. 01）;two groups no significant difference in assessment of anesthesia（P〉0. 05）. A group of adverse reactions were significantly less than group B（P〈0. 01）. Conclusion;Hydrochloric acid for ropivaeaine than bupivaeaine spinal anesthesia＋ epidural anesthesia in gynecologic surgery more safe and effective, more conducive to postoperative recovery.