3%氯普鲁卡因用于低位硬膜外麻醉的临床观察

目的比较3%氯普鲁卡因和2%利多卡因低位硬膜外麻醉的临床效果。方法 40例行下腹部手术患者,随机分成2组,每组20例。对照组:2%利多卡因;试验组:3%氯普鲁卡因。行连续低位(L1～2)硬膜外麻醉。观察感觉阻滞起效时间、感觉阻滞平面上界、运动阻滞起效时间、运动阻滞程度及麻醉质量。结果试验组感觉阻滞起效时间明显快于对照组(P<0.05)。感觉阻滞平面上界2组差异无统计学意义(P>0.05)。运动阻滞起效时间试验组明显快于对照组(P<0.05),但2组Bromage评分在1分以上之和的差异无统计学意义(P>0.05)。对照组和试验组麻醉质量0加1分所占例数的百分比分别为80%和85%(P>0.05)。对照组和试验组患者收缩压在感觉阻滞平面达上界及运动阻滞起效时均明显降低(P<0.05),在整个手术过程中HR和DBP无明显改变(P>0.05)。2组患者术前、术后24h血生化指标差异无统计学意义(P>0.05)。结论 3%盐酸氯普鲁卡因用于低位硬膜外麻醉感觉、运动阻滞起效快于2%利多卡因,但两种局麻药整体麻醉效能相似。

Comparative study of clinical efficiency between 3% chloroprocaine and 2% lidocaine in low-set epidural anesthesia

Objective To compare the clinical efficiency of 3% chloroprocaine and 2% lidocaine in low-set epidural anesthesia. Methods Forty patients （ ASA I - II ） undergoing lower abdominal surgery were randomly divided into two groups, with 20 patients in each group. The 20 patients in control group received continuous low-set（ L1-2 ）epidural anesthesia with 2% lidocaine, however, the other 20 patients in trial group received continuous low-set（ L1 -2 ） epidural anesthesia with 3% chloroprocaine. The onset time of sense blocking, plane upperbound of sense blocking, the onset time of movement blocking, degree of movement blocking and the quality of anesthesia were observed for both groups. Results The onset time of sense blocking in trial group was significantly faster than that of control group（ P 〈 0.05 ）, however, there was no significant difference in plane upperbound of sense blocking between two groups （ P 〉 0.05 ）. The onset time of movement blocking in trim group was significantly faster than that of control group（ P 〈 0.05 ）, however, there was no significant difference in the sum of Bromage scoring（ 〉 lpoint） between two groups（ P 〉0.05 ）. The percentage of cases with anesthesia qualit y（0 or 1 ）was 80% and 85% in control group and trial group,respectively（ P 〈0.05）. The systolic pressure in both groups at plane upperbound of sense blocking and at onset time of movement blocking was significantly decreased（ P 〈0.05 ）, however, hear rate and diastolic blood pressure were not obviously changed during the operation（ P 〉0.05 ）. There were no significant differences in the blood biochemical indicators before operation and 24h after operation between two groups （ P 〉 0.05）. Conclusion The 3 % chloroprocaine can induce earlier onset of sense blocking and movement blocking than 2% lidocaine in low-set epidural anesthesia, but the general anesthesia efficiency in beth drugs is similar in lumbar epidural anesthesia.