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罗哌卡因含或不含肾上腺素硬膜外麻醉的药效学和药代动力学 总被引:10,自引:2,他引:8
目的观察肾上腺素对1%罗哌卡因硬膜外阻滞的药效学和药动学影响。方法选择ASAⅠ~Ⅱ级行下腹部手术病人16例,随机分为两组,每组8例。分别用1%罗哌卡因2mg· kg~-1(R组)和加入1: 200 000肾上腺素的 1%罗哌卡因 2mg· kg~-1(RE组)行硬膜外阻滞,对比两组药效学和药代动力学指标。结果两组药效学指标、Cmax和AUC间均无显著性差异。与R组相比,RE组的Tmax明显后延(P<0.01),K值明显降低(P<0.05)。结论 1:200 000肾上腺素对1%罗派卡因硬膜外阻滞的药效学没有影响,但可以减缓罗哌卡因的吸收和清除。 相似文献
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0.75%罗比卡因与0.75%布比卡因腰麻—硬膜外联合麻醉应用于剖宫产手术的评价 总被引:31,自引:1,他引:30
目的比较0.75%罗哌卡因与0.75%布比卡因腰麻硬膜外联合麻醉用于剖宫产手术的可行性.方法ASAⅠ~Ⅱ级初产妇40例于腰硬联合麻醉下行剖宫产手术,随机、双盲分两组R组(n=20)腰麻用药为0.75%罗哌卡因1.2~1.4ml(9~10.5mg);B组(n=20)腰麻用药为0.75%布比卡因,剂量同R组.术中两组麻醉效应不足时经硬膜外导管补充1.6%利多卡因.术中连续监测呼吸和循环状况,评估麻醉效应,并观察围术期不良反应的发生及新生儿情况.结果两组最高阻滞平面及达到时间相似(P>0.05),但R组感觉和运动神经阻滞起效慢,维持时间短(P<0.05);下肢运动阻滞程度R组显著低于B组(P<0.01);术中R组有4例(20%)发生心动过缓,B组5例(25%)出现主观气促感;新生儿Apgar评分及脐动脉血气值在正常范围内,两组比较无差异(P>0.05).结论0.75%罗哌卡因用于硬腰联合麻醉剖腹产手术安全有效,与0.75%布比卡因相比,下肢运动阻滞弱且恢复迅速. 相似文献
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O.75%罗比卡因与O.75%布比卡因腰麻-硬膜外联合麻醉应用于剖宫产手术的评价 总被引:3,自引:0,他引:3
目的比较0.75%罗哌卡因与0.75%布比卡因腰麻硬膜外联合麻醉用于剖宫产手术的可行性.方法ASA Ⅰ~Ⅱ级初产妇40例于腰硬联合麻醉下行剖宫产手术,随机、双盲分两组:R组(n=20)腰麻用药为0.75%罗哌卡因1.2~1.4ml(9~10.5mg);B组(n=20)腰麻用药为0.75%布比卡因,剂量同R组.术中两组麻醉效应不足时经硬膜外导管补充1.6%利多卡因.术中连续监测呼吸和循环状况,评估麻醉效应,并观察围术期不良反应的发生及新生儿情况.结果两组最高阻滞平面及达到时间相似(P>0.05),但R组感觉和运动神经阻滞起效慢,维持时间短(P<0.05);下肢运动阻滞程度R组显著低于B组(P<0.01);术中R组有4例(20%)发生心动过缓,B组5例(25%)出现主观气促感;新生儿Apgar评分及脐动脉血气值在正常范围内,两组比较无差异(P>0.05).结论0.75%罗哌卡因用于硬腰联合麻醉剖腹产手术安全有效,与0.75%布比卡因相比,下肢运动阻滞弱且恢复迅速. 相似文献
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为探讨盐酸罗哌卡因腰麻加硬膜外阻滞在肛周手术中的麻醉效果,将80例肛周手术患者随机分为两组,分别采用0.5%布比卡因(B组)和0.5%罗哌卡因(L组),施行腰麻加硬膜外阻滞用于肛周手术,观察两组患者感觉阻滞维持时间和麻醉效果。结果显示,两组患者麻醉效果满意率无明显差异,感觉阻滞时间L组明显长于B组。结果表明,0.5%罗哌卡因腰麻加硬膜外阻滞用于肛周手术具有良好的麻醉效果和安全性。 相似文献
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In a single centre, randomised, double-blind study 50 patients scheduled for intra-ocular surgery received 0.75% levobupivacaine or 0.75% racemic bupivacaine for peribulbar anaesthesia. There were no significant differences in the mean (SD) volume of levobupivacaine (11 (2.7) ml) or racemic bupivacaine (10 (2.6) ml) required, time to satisfactory block (levobupivacaine-13 (5.6) min; racemic bupivacaine-11 (4.4) min), peri-operative pain scores or frequency of adverse events between levobupivacaine and racemic bupivacaine. The safer side-effect profile of levobupivacaine may offer significant advantages in the elderly population undergoing cataract extraction in whom intercurrent disease is common. 相似文献
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Background. L-Bupivacaine has a safer side-effect profile thanbupivacaine. We compared the efficacy of a mixture of L-bupivacaine0.75% and lidocaine 2% with bupivacaine 0.75% and lidocaine2% for peribulbar anaesthesia in cataract surgery. Methods. Ninety patients were allocated randomly to receive8 ml of a mixture of equal parts of bupivacaine 0.75% and lidocaine2% or an equal volume of L-bupivacaine and lidocaine 2%. Hyaluronidase15 IU ml1 was added to both solutions. Results. There were significant differences between the groupsin clinical end-points. The median time at which the block wasadequate to start surgery was 4 min (interquartile range48 min) in the bupivacaine group and 8 min (512min) in the L-bupivacaine group (P=0.002). Median ocular andeyelid movement scores were similarly significantly decreasedin the bupivacaine group compared with the L-bupivacaine groupat all times (P0.03). There was no difference between groupsin the incidence of minor complications. Conclusions. A mixture of bupivacaine 0.75% and lidocaine 2%provides faster onset time than a mixture of L-bupivacaine 0.75%and lidocaine 2%. Br J Anaesth 2003; 90: 51214 相似文献
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0.75%罗比卡因与0.75%布比卡因应用于肾移植术的比较 总被引:1,自引:0,他引:1
目的 比较0.75%罗比卡因与0.75%布比卡因硬膜外麻醉用于肾移植术的临床效果。方法 肾移植术者24例,随机分为R1组和B1组,每组12例,肾功能正常行下腹或下肢手术者20例,随机分为R2组和B2组,每组10例,硬膜外分别注入0.75%罗比卡因或0.75%布比卡因16ml,监测循环改变,测定感觉阻滞及下肢运动阻滞效果。结果 R1组运动阻滞达峰时间及麻醉起效时间明显慢性B1组。运动阻滞维持时间R1组短于B1组。最高感觉阻滞平面,感觉阻滞达峰时间及维持时间R1组与B1组相似,B2组运动阻滞达峰时间短于R2组,感觉阻滞达峰时间R1组短于R2组,B1组短于B2组,维持时间R1组长于R2组,B1组长于B2组。结论 行肾移植术者无论使用罗比卡因还是布比卡因,其感觉阻滞达峰快,作用维持时间长。0.75%罗比卡因与0.75%布比卡因相比,感觉阻滞起效慢,运动阻滞达峰时间慢而维持时间短,但罗比卡因组血液动力学稳定。 相似文献
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Casati A Vinciguerra F Santorsola R Aldegheri G Putzu M Fanelli G 《European journal of anaesthesiology》2005,22(6):452-456
BACKGROUND AND OBJECTIVE: This prospective, randomized, double-blind study was conducted to evaluate the onset time and duration of sciatic nerve block produced with 0.5% levobupivacaine, 0.75% levobupivacaine and 0.75% ropivacaine. METHODS: Forty-five healthy patients undergoing hallux valgus repair were randomly allocated to receive sciatic nerve block with levobupivacaine 0.5% (n=15), levobupivacaine 0.75% (n=15) or ropivacaine 0.75% 20 mL (n=15). A femoral nerve block was also performed with mepivacaine 2% 15 mL to cover pain related to the thigh tourniquet. A blinded observer recorded the onset time and duration of sciatic nerve block. RESULTS: The median (range) onset time was 5 (5-40) min with 0.75% levobupivacaine, 30 (5-60) min with 0.5% levobupivacaine and 20 (5-50) min with 0.75% ropivacaine (P = 0.02 and P = 0.12, respectively). Mean (25-75 percentiles) first request for pain medication occurred after 13 (11-14) h with 0.75% ropivacaine, 18 (15-19) h with 0.75% levobupivacaine and 16 (13-20) h with 0.5% levobupivacaine (P = 0.002 and P = 0.002, respectively). Rescue tramadol after surgery was required by three patients in the 0.75% levobupivacaine group, eight patients in the 0.5% levobupivacaine group and nine patients in the 0.75% ropivacaine group (P = 0.05). CONCLUSIONS: We conclude that 0.75% levobupivacaine provides a shorter onset time than 0.5% levobupivacaine and a longer duration of postoperative analgesia than both 0.5% levobupivacaine and 0.75% ropivacaine with reduced need for rescue analgesia after surgery. 相似文献
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Three millititre of 0.75% plain bupivacaine and 0.5% amethocaine3 ml in 5% glucose were used for spinal anaesthesia and comparedin a double-blind study of 20 patients undergoing urologicalsurgery. The onset time to maximum cephalad spread of sensoryanalgesia was approximately 45 min for bupivacaine and approximately30 min in the amethocaine group (ns). The mean maximum spreadof sensory analgesia was similar for both agents: T6-7 180 minafter injection, although the cephalad spread of sensory analgesiawith bupivacaine persisted for longer at a significantly higherlevel than that of amethocaine. Duration of sensory analgesiawas significantly longer in the bupivacaine group from S3 toS5 and from T12 to L2 levels. Onset time to complete motor blockadeof the lower limbs was similar for both agents. Nine of 10 bupivacainepatients and seven of the 10 patients receiving amethocainehad complete motor blockade of the lower limbs. Duration ofmotor blockade was significantly longer for all degrees in thebupivacaine group. 相似文献
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We have compared the efficacy of 1% ropivacaine with a mixture of 0.75%
bupivacaine and 2% lidocaine for peribulbar anaesthesia in cataract
surgery. We used the time to adequate block for surgery, and ocular and
eyelid movement scores at 8 min after block as clinical end-points. Ninety
patients were allocated randomly to receive 7-10 ml of a mixture of equal
parts of 0.75% bupivacaine and 2% lidocaine or an equal volume of 1%
ropivacaine alone. Hyaluronidase 15 iu ml-1 was added to both solutions.
There were no differences between groups in clinical end- points. Median
time at which the block was adequate to start surgery was 8 min
(interquartile range 4-10 min) in each group. Median eyelid movement scores
were similar in both groups, but the bupivacaine and lidocaine mixture
produced a significantly decreased ocular movement score at 2, 4 and 6 min
(P < 0.05). There was no difference between groups in the incidence of
minor complications. Based on clinical end- points, time to adequate block
for surgery and median ocular and eyelid movement scores at 8 min, 1%
ropivacaine as the sole agent for peribulbar anaesthesia was comparable
with a mixture of 0.75% bupivacaine and 2% lidocaine.
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