罗哌卡因与左旋布比卡因用于腹部手术腰硬联合麻醉效果比较

目的:比较罗哌卡因与左旋布比卡因在腹部手术腰硬联合麻醉中的效果安全性。方法:腰硬联合麻醉的腹部手术患者86例随机分为A、B两组各43例。A组采用罗哌卡因麻醉、B组采用左旋布比卡因麻醉,比较两组患者麻醉效果、各时间点患者血流动力学变化,及药品不良反应发生情况。结果:两组患者感觉阻滞时间比较,差异无统计学意义(P>0.05),而A组术后运动神经恢复时间显著短于B组(P<0.05),Bromege评分也显著低于B组(P<0.05)。两组患者麻醉阻滞起效后SBP、DBP、HR等指标均较麻醉前显著降低(P<0.05),而麻醉结束后两组收缩压(SBP)、舒张压(DBP)、心率(HR)与麻醉前比较,差异无统计学意义(P>0.05)。术中各时间点两组SBP、DBP、HR等指标比较,差异也无统计学意义(P>0.05)。两组药品不良反应发生率比较,差异无统计学意义(P>0.05)。结论:罗哌卡因与左旋布比卡因对患者感觉神经的阻滞作用相当,对患者血流动力学的影响及药品不良反应发生率也基本相同。而罗哌卡因对于运动神经的阻滞作用较弱,更有利于患者术后早期运动。

Comparison of Anesthesia Effect of Ropivacaine and Bupivacaine in Combined Spinal Epidural Anesthesia in Abdominal Operation

ABSTRACT Objective: To compare the efficacy and safety of ropivacaine and bupivacaine in combined spinal epidural anesthesia in abdominal operation. Methods:Totally 86 abdominal operation patients with combined spinal epidural anesthesia were randomly divided into group A and group B with 43 ones in each. Group A was with ropivacaine anesthesia, while group B was with levobupivacaine anesthesia. The anesthesia effect, hemodynamic changes at different time points and adverse drug reactions were compared between the two groups. Results: The duration of sensory block in the two groups was not statistically different (P>0.05), while the patients in group A had shorter motor nerve recovery time than those in group B (P<0.05), and Bromege score of group A was significantly lower than that of group B (P<0.05). After the onset of anesthesia block, all hemodynamic parameters (SBP, DBP and HR) in the two groups were lower than those before the anesthesia (P<0.05), while at the end of anesthesia, the parameters showed no statistically significant difference from those before the anesthesia (P>0.05). During the operation, the parameters at different time points in group A had no significant difference from those in group B (P>0.05). The incidence of adverse drug reaction was not statistically significant between the two groups as well (P>0.05). Conclusion:Ropivacaine and levobupivacaine show similar blocking effect on the sensory nerve with the same effects on hemodynamics and adverse reactions, however, the blocking effect of ropivacaine on motor nerve is weaker, which is more beneficial to the early exercise of the patients after operation.