布比卡因、左旋布比卡因和罗哌卡因的剖宫产硬膜外阻滞效果比较

目的:比较3种局麻药用于剖宫产硬膜外阻滞的麻醉效果与不良反应。方法:在硬膜外阻滞下行剖宫产手术的90例产妇被随机分为3组。硬膜外穿刺置管成功后,先给试验量含1:200 000肾上腺素的2%利多卡因3 ml,再分别给予浓度均为0.5%的布比卡因、左旋布比卡因和罗哌卡因中的一种,分次给药。记录各组的感觉和运动阻滞的起效、时效及不良反应。结果:3组均有较好的麻醉镇痛效果,但有一些肌松不满意的病例。罗哌卡因组的感觉阻滞起效、时效较其他两组长,但尚无统计学差异;其运动阻滞起效与时效和运动阻滞程度均不及其他两组,且有统计学差异(P<0.05)。3组均未发生严重不良反应。结论:硬膜外0.5%布比卡因、左旋布比卡因或罗哌卡因用于剖宫产均有较好的麻醉镇痛效果,有一些肌松不满意的病例;但罗哌卡因的运动阻滞起效与时效和运动阻滞程度均不及其他两药。

The Anesthetic Effects Reactions of Epidural Bupivacaine, Levobupivacaine and Ropivacaine for Cesarean Section

Objective:To study the anesthetic effects and adverse reactions of epidural bupivacaine,levobupivacaine and ropiva- caine for cesarean section.Methods:Ninety parturient women scheduled for cesarean section under epidural block were assigned to receive one of the three local anesthetics.After the test dose of 2% lidocaine 3 ml containing epinephrine 1:200,000,one of the three local anesthetics with concentration 5% and total dose 14 ml were given for three times.The onset and duration of ac- tion of sense and motor block and advese reactins were recorded.Results:Good analgesic effects were obtained in all the three groups,but there were some cases with unsatisfied muscle relaxation.Comapared to bupivacaine and levobupivacaine groups, the onset time and duration of action of sense block in ropivacaine group were longer,but no significant differences was foumd, but the onset time and duration of action of motor block were shorter and extent of motor block were deeper with significant differences.No severe adverse reaction happened in the three groups.Conclusion:Epidural 0.5% bupicavaine,levobupivacaine or ropivacaine could cause good analgesic effects,but the motor block of ropivacaine was inferior to that of levobupivacaine or ropivacaine.