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[1]宗 林,赵 兵,王建国,等.罗哌卡因与布比卡因行连续蛛网膜下腔 麻醉的效果观察[J].医学研究与战创伤救治(原医学研究生学报),2009,11(02):107-108，133.
　ZONG Lin,ZHAO Bing,WANG Jian-guo,et al.Study of isobaric bupivacaine and ropivacaine in continuous spinal anesthesia for abdominal operation[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(02):107-108，133.
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罗哌卡因与布比卡因行连续蛛网膜下腔 麻醉的效果观察()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第11卷
期数:
2009年02期
页码:
107-108，133
栏目:
出版日期:
2009-03-20

文章信息/Info

Title:
Study of isobaric bupivacaine and ropivacaine in continuous spinal anesthesia for abdominal operation
文章编号:
1672-271X(2009)02-0107-03
作者:
宗 林; 赵 兵; 王建国; 杜云翔
解放军第82医院，江苏淮安 223001
Author(s):
ZONG Lin;  ZHAO Bing; WANG Jian-guo; DU Yun-xiang
The 82th Hospital of PLA, Huai'an 223001,Jiangsu,China
关键词:
连续蛛网膜下腔麻醉; 布比卡因; 罗哌卡因
Keywords:
Continuous spinal anesthesia; Ropivacaine; Bupivacaine
分类号:
R614.4＋1
DOI:
-
文献标志码:
A
摘要:
目的 观察罗哌卡因与布比卡因连续蛛网膜下腔阻滞用于腹部手术的安全性和可行性。方法 择期行腹部手术患者60例,取L2-3间隙行连续蛛网膜下腔麻醉，用药为罗哌卡因与布比卡因，根据药物浓度不同随机分为三组:Ⅰ组0.5%布比卡因、Ⅱ组0.5%罗哌卡因、Ⅲ组0.75%罗哌卡因，每组20例，经蛛网膜下腔导管给药, 初次剂量均为3 ml，根据需要追加药量0.5～1 ml，使麻醉平面达T4水平，此为基础剂量，记录基础剂量后最高痛觉消失平面节段、感觉阻滞起效时间、最高锐痛觉阻滞平面下降一节段时间、镇痛效果及肌松程度，记录各组给药后不同时点平均动脉压、心率、血氧饱和度值。结果 Ⅱ组和Ⅲ组与Ⅰ组相比:除最高痛觉消失平面无显著性差异外，其余各项指标均差异显著，Ⅱ组和Ⅲ组感觉阻滞起效时间较慢(P<0.05)，而最高锐痛觉阻滞平面下降一节段时间明显增快(P<0.01)；镇痛和肌松效果方面，Ⅰ组和Ⅲ组相当，但显著优于Ⅱ组(Ｐ<0.01)。结论 0.75%罗哌卡因行连续蛛网膜下腔麻醉，其镇痛及肌松效果与0.5%布比卡因相当，但对循环抑制轻，并发症少，可用于腹部手术。
Abstract:
Objective To investigate the feasibility and safety of isobaric bupivacaine and ropivacaine in continuous spinal anesthesia for abdominal surgery.Methods 60 paitents (ASAⅠ～Ⅱ) for abdominal surgery were randomly divided into 3 groups, 20 patients were included in each group. GroupⅠ: 0.5% bupivacaine solutions, GroupⅡ: 0.5% ropivacaine solutions, Group Ⅲ: 0.75% ropivacaine solutions. First intrathecal injection bupivacaine or ropivacaine 3ml and adding 0.5～1 ml to achieve T4 plane of analgesia. The following variables were measured: the highest analgesic level, time to reach complete plane of analgesia, analgesia effects, and extent of muscle blockade. Mean arterial pressure, heart rate, oxygen saturation were recorded.Resluts There was no statistical difference among the basic conditions (P>0.05). Compare group Ⅱand Ⅲ with groupⅠ, all the observed indexes including the onset time and duration of motor blockade showed significant difference, except the anesthetic level was similar. The anesthesia effects of groupⅠ and groupⅢ were significantly better than groupⅡ, but the mean arterial pressure (MAP) in groupⅠdecreased obviously after the intrathecal injection than the other groups (P<0.05).Conclusion The 0.75% isobaric ropivacaine used during continuous spinal anesthesia in the abdominal surgery produces a suitable and a more controllable anesthesia, but there need advanced study and more clinical data in the true sea rescue and surgery.

参考文献/References:

[1]Minville V, Fourcade O, Grousset D, et al. Spinal anesthesia using single injection small-dose bupivacaine versus continuous catheter injection techniques for surgical repair of hip fracture in elderly patients[J]. Anesth Analg, 2006, 102(5): 1559-1563.
[2]Mollmann M. Spinocath, a new approach to continuous spinal anesthesia preliminary result of a multicenter trail[J]. International Monitor on Regional Anaesthesia, 1996, 8(1):74.
[3]贺 民，郭曲练. 0.5%重比重布比卡因溶液用于连续蛛网膜下腔阻滞不同给药方式麻醉效果的比较[J].中华麻醉学杂志，2003, 23(9):704-705.
[4]Kallio H, Snall EV, Tuomas CA, et al. Comparison of hyperbaric and plain ropivacaine 15 mg in spinal anaesthesia for lower limb surgery[J]. Br J Anaesth, 2004, 93(5): 664-669.
[5]Kallio H, Snall EV, Tuomas CA, et al. A comparison of intrathecal plain solutions containing ropivacaine 20 or 15mg versus bupivacaine 10mg[J]. Anesth Analg, 2004, 99(3): 713.
[6] Khaw KS,Ngan Kee WD,Wong EL,et al.Spinal ropivacaine for cesarean section:a dose-finding study[J].Anesthesiology,2001,95(6): 1346-1350.
[7]Malinovaky JM,Charles F,Kick O,et al.Intrathecal anesthesia:ropivacaine versus bupivacaine[J].Anesth Analg,2000,91(6):1457-1460.
[8]李建玉，吴新文，曹云飞，等. 0.75％罗哌卡因和0.5％布比卡因用于摇摆状态下蛛网膜下腔阻滞的比较研究[J]. 解放军医学杂志，2006, 31(6):629-631.

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备注/Memo

备注/Memo:
2008年南京军区医学科技创新课题(08MA038)
更新日期/Last Update: 2013-11-20