罗哌卡因与布比卡因腰麻对心率变异性的影响

目的 评估罗哌卡因腰麻对心率变异性的影响及其安全性。方法 80例患者随机分为2组：罗哌卡因组（R）和布比卡因组（B），每组40例。在分别予0．5％的罗哌卡因和布比卡因蛛网膜下腔给药后，监测并记录注药前、注药后5min、10min、20min时MAP、HR、LF、HF、LF／HF、TF数值。结果 罗哌卡因组LF、TF、LF／HF均呈下降趋势，10min和20min数值与基础值比较具有显著性（P〈0.05）；布比卡因组MAP、LF、TF、LF／HF下降明显，给药后5min数据与基础值比较具有显著性（P〈0．05），10min、20min数值与基础值比较具有非常显著性（P〈0．01）；组间比较，布比卡因组MAP、TF、5min LF、LF，／HF与同时段罗哌卡因组比较有显著性差异（P〈0．05），10min和20min LF、LF／HF差异具有非常显著性（P〈0．01）；两组患者HR和HF虽也呈下降趋势，但与基础值比较并不具有显著性（P〉0．05）。结论 0．5％的罗哌卡因腰麻对心率变异性的影响要显著小于同浓度的布比卡因，该浓度的罗哌卡因腰麻安全性要高于布比卡因。

The effect of spinal ropivacaine and bupivacaine on heart rate variability

Objective To assess the effect and safety of 0.5%spinal ropivacaine on heart rate variability. Methods Eighty ASA I-II patients scheduled for elective lower abdominal or lower limbs operations were randomized to receive 0.5%spinal ropivacaine (group R, n=40) or bupivacaine (group B, n=40). MAP, HR, LF, HF, LF/HF and TF were monitored and recorded before injection, at 5 min, 10 min and 20 min after injection. Results LF, TF and LF/HF in group R decreased together, and there were significant difference between the data at 10 min, 20 min after injection and baseline. MAP, LF, TF and LF/HF in group B also decreased, and there were significant changes between the data at 5 min after injection and baseline, and there were very significant changes between the data at 10 min, 20 min after injection and baseline. MAP, TF, LF and LF/HF at 5 min after injection in group B were significantly lower than those in group R. LF and LF/HF at 10 min and 20 min after injection in group B were very significantly lower than those in group R. HR and HF also reduced in both groups, but there were no significant difference compared with baseline. Conclusion 0.5%spinal ropivacaine is less effective than bupivacaine on heart rate variability, and it is safer than bupivacaine.