利多卡因和左旋布比卡因在高龄低位硬膜外麻醉中的对比研究

目的 比较利多卡因和左旋布比卡因在高龄病人低位硬膜外麻醉（T12以下）中的作用及对循环的影响。方法 选择50例施行低位硬膜外麻醉的高龄病人，随机分为A、B两组，A组用2％利多卡因；B组用0．75％左旋布比卡因，比较两组循环（心率、平均动脉压）、起效时间、感觉运动阻滞时间、感觉运动恢复时间的差异，以及两种药物的副作用特别是过敏反应情况。结果 两组心率变化不大，A组病人平均动脉压比B组低（P〈0．05）；利多卡因起效时间较左旋布比卡因短，作用时间短，两种药物麻醉中没有出现明显的过敏反应。结论 高龄病人低位硬膜外麻醉中应用利多卡因有诸多不足，对循环影响较大，如应用左旋布比卡因更有利于高龄病人，循环更稳定。

A comparative study of lidocaine and levobupivacaine for low position epidural anaesthesia in senile patients

Objective To compare the effect of lidocaine and levobupivacaine on low position epidural anaesthesia(under the position of T12) and the influence on circulation in senile patients.Methods Fifty senile patients who would perform low position epidural anesthesia,including 32 males and 18 females,the age ranging from 70 to 99 years old,were divided randomly into two groups with 25 in each.2% lidocaine was used in group A,and 75% levobupivacaine in group B.The HR,MAP,the time for anaesthesia to take effect,time for blocking and recovering sense and motion,and side effects especially allergy were compared between the two drugs.Results Patients' HR in the two groups changed slightly.Patients in group A had lower MAP,with a significant difference as compared with group B(P<0.05).The starting and acting time of anaesthesia was shorter for lidocaine than levobupivacaine.There was not obvious allergy in two groups.Conclusion We prefer levobupivacaine rather than lidocaine in low epidural anesthesia of senile patients because the latter is more safe and has less influence on circulation during anaesthetic period.