摘要
目的探讨盐酸氯普鲁卡因复合罗哌卡因在下腹部或下肢手术硬膜外麻醉中的麻醉效果。方法随机选择80例择期行下腹部或下肢手术的患者,随机分成4组,每组20例,观察组(C+R组)注入3%盐酸氯普鲁卡因和1%罗哌卡因各10ml;对照1组(L组)注入2%盐酸利多卡因20ml;对照2组(C组)注入3%盐酸氯普鲁卡因20ml;对照3组(L+R组)注入2%利多卡因和1%罗哌卡因各10ml。观察痛觉阻滞起始、完全消失、恢复时间,运动阻滞起始及恢复时间,观察中枢神经系统的变化及过敏反应。结果观察组和C组的麻醉起效、痛觉减退、痛觉消失时间均较L组、L+R组缩短(P<0.01),但C组在麻醉后20min时与观察组比较对MAP出现显著影响(P<0.01)。观察组和L+R组的痛觉恢复、运动恢复较其他二组显著延长(P<0.01);观察组在麻醉后20min时和L组、L+R组比较血压下降(P<0.05)。结论 3%盐酸氯普鲁卡因能使麻醉起效时间显著提前,1%罗哌卡因能使麻醉作用时间显著延长;单纯盐酸氯普鲁卡因对血压影响大,符合罗哌卡因后对血压的影响减小,3%盐酸氯普鲁卡因复合1%罗哌卡因用于硬膜外麻醉起效快,效果完善,作用时间稳定,对血压影响不大,在临床上可供推广。
Objective To investigate the effect of chloroprocaine and ropivacaine mixture in patients undergoing abdomen and limb operations with epidural blockade. Methods Eighty patients （ASA Ⅰ ～ Ⅱ ） underwent abdomen and limb operations were randomly divided into four grounps： grounp C＋R （n=20）, grounp L （n=20）, grounp C （n=20）, grounp L＋R（n=20）. In grounp C＋R, the mixture of 3% chloroprocaine and 1% ropivacaine was used. The 2% lidocaine was used in grounp L. The 3% chloroprocaine was used in grounp C. The mixture of 2% lidocaine and 1% ropivacaine was used in grounp L＋R. The onset, duration time of sensory and motor blockade, BP,HR,RR, SpO2 were recorded as usual. The occurrence of response of nervous system and allergic reactions were observed. Results 3% chloroprocaine could shorten the onset time of anaesthesia and 1% ropivacaine could prolong the duration of anaesthesia; 3% chloroprocaine could reduce MAP and was further reduced by mixing 1% ropivacaine. Conclusion 3% chloroprocaine mixed with 1% ropivacaine in epidural blockade anaesthesia can shorten the onset time and prolong the duration time with no evident effect on calculation. This mixture can be used widely in epidural blockade anaesthesia.
出处
《北京医学》
CAS
2010年第10期831-833,共3页
Beijing Medical Journal
关键词
硬膜外麻醉
盐酸氯普鲁卡因
罗哌卡因
局麻药
Epidural blockade anaesthesia Chloroprocaine Ropivacaine Local anesthetic
