左旋布比卡因与罗哌卡因应用于臂丛神经阻滞的临床对比研究

目的 比较左旋布比卡因和罗哌卡因用于肌间沟臂丛神经阻滞的效果及不良反应。方法 本组自2007年5月～12月对60例行上肢手术患者，ASAI～Ⅱ级，分为罗哌卡因（R）组和左旋布比卡因（L）组，每组30例，采用肌间沟法行臂丛神经阻滞，观察感觉／运动神经阻滞的起效时间及持续时间、患者对神经阻滞满意度、不良反应。结果 两组间感觉神经和运动神经阻滞起效时间的差异无显著性（P〉0．05）；L组的感觉和运动神经阻滞持续时间显著长于R组（P〈0．05），神经阻滞优良率均为100％。结论 左旋布比卡因与罗哌卡因均可安全用于临床肌间沟臂丛神经阻滞，二者有相似的药效学特性，但左旋布比卡因在术后镇痛方面略优于罗哌卡因。

A clinical comparison between levo-bupivacaine and ropivacaine in the use of brachial plexus blockage

Objective To compare the therapeutic efficacy and side effects of levo- bupivacaine and ropivacaine in the use of brachial plexus blockage. Methods 60 patients received upper limb operations, ASA scored I～II, were divided into to group ropivacaine （R,n=30） and group levo-bupivacaine （L,n=30）. The brachial plexus block was used. The nerve block onset time and duration, analgesia quality and side effects were observed. Results The block onset time of sensory nerve and motor nerve showed no significant differences between the two groups （P〉0.05）, but the block durations of sensory nerve and motor nerve of group L were significantly longer than that group R（P〈0.05）. The excellent and good rates were 100% in two groups. Conclusions leve-bupivacaine and ropivacaine of nervous block were could be safely used to block brachial nerve of intermuscular groove. The two anes-thetic drugs have a similar feature of pharmaco-dynamics, but Leve-bupivocaine in suoerior to rooivacaine in oostoperative analgesia.