罗哌卡因与布比卡因颈丛阻滞的临床比较

目的：研究低浓度罗哌卡因颈丛阻滞的麻醉效果和安全性。方法：62例无心脏病史、拟行甲状腺瘤切除术的患者随机分为罗哌卡因组32例和布比卡因组30例。两组患者分别以0．375％的罗哌卡因和0．375％的布比卡因24 ml行一针法双侧颈丛阻滞。观察麻醉起效时间、阻滞完善程度、镇痛持续时间及麻醉并发症，同时以惠普多功能监护仪连续监测血压（BP）、心率（HR）、心电图（ECG）和脉搏血氧饱和度（SPO2）。结果：与罗哌卡因组相比，布比卡因组的镇痛持续时间明显延长，但其异常ECG的发生率也显著升高（均P ＜ 0．05）。两组异常的BP、HR和其他并发症的发生率无显著性差异。结论：颈丛阻滞使用低浓度罗哌卡因可取得满意的麻醉效果并具有较高的安全性。

CLINICAL COMPARISION BETWEEN ROPIVACAINE AND BUPIVACAINE IN CERVICAL PLEXUS BLOCK

Objective： To study the anesthesia effect and safety of ropivacaine in low concentration for cervical plexus block． Method： 62 patients without cardiac disease undergoing the thyroid tumor operation were randomly divided into two groups： ropivacaine group （n＝32） and bupivacaine group （n＝30）． 24 ml ropivacaine （0．375％） and equivalent bupivacaine （0．375％） were used in two groups respectively for cervical plexus block by one－needle method． The time of anesthesia induction， the time of analgesia， block degree and anesthesia complication were observed． Meanwhile， blood pressure （BP）， heart rate （HR）， electrocardiogram （ECG） and pulse oxygen saturation were monitored continuously by multifunctional monitor． Results： Compared with ropivacaine group， the time of analgesia in bupivacaine group was longer （P ＜ 0．05）， but the incidence of abnormal ECG was higher （P ＜ 0．05） in this group． There were no significant difference in the incidences of abnormal BP， HR and other complications． Conclusion： ropivacaine in low concentration can produce a satisfactory anesthesia effect and has great security．