左布比卡因骶管麻醉在小儿手术中的应用

目的:对小儿病人实施新的局部麻醉剂左布比卡因骶管麻醉,将左布比卡因及布比卡因的临床作用及血液动力学影响进行比较,并对左布比卡因的药效学进行了分析。方法:将78名2004年6～12月在我院施行择期手术的小儿随机分为A、B两组,每组39例,A组注入0.25%左布比卡因0.8ml/kg;B组注入0.25%布比卡因0.8ml/kg。术后在苏醒室监测病人的麻醉镇痛时间、血液动力学改变并观察两组的麻醉时间及运动恢复时间。结果:所有小儿均获得满意的麻醉效果,两组的镇痛时间类似,A组的镇痛时间为223±37min,B组的镇痛时间为216±29min,差异不显著。所有小儿均出现明显的平均动脉压下降及心率减慢,A组的平均动脉压及心率分别下降到74±19mmHg及70±16次/min,而B组为77±18mmHg及73±21次/min,两组差异不显著。结论:左布比卡因骶管麻醉提供了有效的小儿麻醉镇痛。麻醉效果与布比卡因类似而心脏毒性较低。

Caudal levobupivacaine in children

Objective:Levobupivacaine, a new local anesthetic, is less cardiotoxic than racemic bupivacaine, while retaining similar local anesthetic property and potency to racemic bupivacaine. The authors evaluated the clinical effects and hemodynamic effects of levobupivacaine compared with bupivacaine when given for caudal blocks in children.Methods:78 patients were randomly divided into two groups of 39 patients each.Group A and group B received a caudal injection of 0.25% levobupivacaine (0.8 ml/kg) and of 0.25% bupivacaine (0.8 ml/kg) respectively.. Postoperative observations included the duration of analgesia, hemodynamic, invalid anesthetic time and motion recovery time in recovery room.Results:All patients had satisfactory anesthesia and similar longer duration of analgesia was observed in both group..Analgesic duration were (223±37) min in group A and(216±29)min in group B.All patients showed a significant decrease in mean arterial blood pressure and heart rate.The lowest mean systolic blood pressure and heart rate were, respectively,(74±19)mmHg and (70±16) beats/min in group A versus (77±18) mmHg and (73±21) beats/min in group B.Conclusion:Caudal levobupivacaine could provid effective analgesia in small children.