不同浓度甲磺酸罗哌卡因用于成人骶管阻滞的比较(1)
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[摘要] 目的：通过对比不同浓度甲磺酸罗哌卡因成人骶管阻滞的效果，探讨其最佳浓度。方法：选择ASAⅠ~Ⅱ级肛肠手术患者90例随机分为A、B、C组，每组各30例，均注入1%盐酸利多卡因5 ml作为试验量局麻药，3 min后患者若无局麻药中毒和全脊麻症状，则分别骶管内给予0.298%(A组)、0.447%(B组)、0.596%(C组)浓度甲磺酸罗哌卡因各15 ml。记录感觉神经阻滞起效时间、最高阻滞平面、阻滞持续时间、循环系统变化及不良反应情况。结果：全部患者麻醉平面均固定于T10以下，A组麻醉起效时间[(11.2±4.6)min]明显长于B组和C组[(7.4±3.2)、(6.7±3.3)min]，而麻醉维持时间[(2.1±0.4)h]明显少于B组和C组[(4.0±2.1)、(4.8±1.9)h]，且麻醉效果差于B组和C组，差异均有统计学意义(均P<0.05)；B组和C组麻醉效果良好，麻醉起效时间和维持时间比较，差异无统计学意义(P>0.05)。A组1例患者出现术后恶心呕吐(PONV)，B组1例、C组3例患者术后出现尿潴留。结论：0.447%浓度甲磺酸罗哌卡因是应用于成人骶管阻滞的理想浓度。
[关键词] 甲磺酸罗哌卡因；骶管阻滞；成人
[中图分类号] R971.2 [文献标识码] A [文章编号] 1673-7210(2011)11(b)-074-03
Efficacy comparison of different concentration of Ropivacaine Mesylate application in adult caudal block
LU Ping
Department of Anesthesia, the Centre Hospital of Huludao City, Liaoning Province, Huludao 125000, China
[Abstract] Objective: To evaluate the efficacy of different concentration of Ropivacaine Mesylate application in adult caudal block, in order to discuss the best concentration. Methods: 90 cases of ASA Ⅰ-Ⅱ patients who were scheduled for anorectal surgery under caudal anesthesia were randomly divided into A, B, C group, each of 30 cases. 1% Lidocaine Hydrochloride 5 ml was given to the patients of three groups for caudal block as a test dose, 3 min later if the patients did not feel any discomfort, then 0.298% (group A), 0.447% (group B), 0.596% (group C) Ropivacaine Mesylate 15 ml were injected in sacral canal respectively. Anesthesia effect of onset and duration time of sensory block, the highest block plane, circulation system changes and adverse reactions were recorded. Results: The anesthesia onset time of group A [(11.2±4.6) min] was significantly longer than that of group B and group C [(7.4±3.2), (6.7±3.3)min] (P<0.05), and the duration time of group A [(2.1±2.4) h] was significantly shorter than that of group B and C [(4.0±2.1), (4.8±1.9) h] (P<0.05). The anesthesia effect was also worse of group A than that of group B and C, the differences were statistically significant (P<0 ......
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