低容量罗哌卡因硬膜外麻醉用于椎间盘镜髓核摘除术

目的比较低容量不同浓度的罗哌卡因在腰段硬膜外麻醉行椎间盘镜手术时的临床效果. 方法 150例临床拟行椎间盘镜髓核摘除术病人,随机分为0.8%罗哌卡因(n=50),0.6%(n=61),0.4%(n=39)3组.硬脊膜外穿刺置管后,给2%利多卡因5ml试验量,有麻醉平面后,每组分别一次性注入不同浓度罗哌卡因5ml.以Bromage分级法判断运动神经阻滞分级,比较起效、恢复时间和分离麻醉情况. 结果神经阻滞起效时间感觉神经小于运动神经,而其维持时间大于运动神经.Ⅱ组对感觉、运动神经阻滞分离明显,与Ⅰ、Ⅲ组比较P＜0.01. 结论 0.6%的低容量罗派卡因用于椎间盘镜手术时,对感觉、运动神经阻滞分离效果满意,麻醉的起效时间随药物浓度递增而加快.

A study on low volume of ropivacaine used in epidural anaesthesia during microendoscopic discectomy(MED)

Objective To compare the clinical effects of different concentrations of low volumn of ropivacaine during MED. Methods 150 patients performed MED were randomly divided into three groups: in the first group (n=50) 0.8% ropivacaine was used, in the second group (n=61) 0.6% Ropivacaine was used and in the third group 0.4% Ropivacaine was used. First epidural needle was introduced into the epidural space. Then edpidual catheter was introduced into the epidural space and 5ml of 2% lidocaine was injected. After anesthesia planum was obtained, 5ml of ropivacained in different concentrations was iniected through the epidural catheter in different groups. The react time, the resume time and the separate anaesthesia among three groups were compared Results The blockade of sensory nerve was faster than that of motor nerve, and persistent time of sensory nerve was longer than that of motor nerve. Group two had more remarkable separate sensory and motor blockade than group one and group three (P<0.01). Conclusions Use of 0.6% Ropivacaine during MED can result in a satisfied separate sensory and motor blockade, and the response of anaesthesia becomes faster with the increase in drug concentration.