罗哌卡因和布比卡因对心脏毒性作用的比较

目的 :探讨 1%罗哌卡因和 0 .75 %布比卡因用于硬膜外麻醉时对心脏的毒性作用。方法 :选择择期硬膜外麻醉患者 4 0例 ,ASAⅠ级～Ⅱ级。随机分为罗哌卡因组 (R组 ,2 0例 )和布比卡因组 (B组 ,2 0例 ) ,分别于麻醉前 (T0 )和麻醉平面绝对后 (T1)抽取静脉血 3mL ,测定血清心肌肌钙蛋白I(cTnI)的浓度 ,CK MB与CK的活性 ,记录相应时点的MAP ,HR和SpO2 值。结果 :两组患者于麻醉平面绝对后相应指标均较麻醉前有所增高 (P <0 .0 1)。两组间相比麻醉平面绝对后相应指标R组低于B组 ,但无统计学意义 (P >0 .0 5 )。结论 :罗哌卡因用于硬膜外麻醉时对心脏的毒性作用小于布比卡因 ,对血流动力学的影响小 ,用于心脏病非心脏手术的患者较布比卡因安全可靠。

To compare the cardiac poisonous effects between ropivacaine and bupivacaine

Objective:To compare the cardiac poisonous effects between 1% ropivacaine and 0. 75% bupivacaine.Methods:To choose forty patients who will undergo epidural anest hesia were divided into two groups.Ropivacaine group (R group,20 cases),bupivaca ine group(B group,20).Blood samples were taken from veins for concentration of c TnI and myocardial enzemy(cK-MB CK)before anesthesia and after the anesthesic l evels were firmed.Results:cTnI,CK-MB,CK levels were markedly higher after anest hesia in two groups(P￡0.01).The value of R is lower than that in B,but ther e was no difference between two groups(P￡0.05).Conclusion:The cardiac poiso nous effects of ropivacaine was weaken than those of bupivacaine.It is safer for ropivacaine to use in the heart disease than bupivacaine does.