【摘要】 目的比较相同浓度罗比卡因和利多卡因与布比卡因和利多卡因用于颈神经丛阻滞的麻醉效果。方法50例ASAⅠ—Ⅱ级甲状腺肿物切除患者随机分成两组,罗比卡因混合液(Ⅰ组)32例,布比卡因混合液(Ⅱ组)18例,分别用0.5%罗比卡因和1%利多卡因与0.5%布比卡因和1%利多卡因10ml阻滞颈浅神经,再分别用0.5%罗比卡因和1%利多卡因与0.5%布比卡因和1%利多卡因6ml阻滞颈深神经丛。记录麻醉效果及产生的并发症,记录麻醉前(T0)、麻醉后即刻(T1)、麻醉后的5min(T2)、10min(T3)、15min(T4)、30min(T5),及手术结束(T6)时的HR、SBP、DBP、MAP、SpO2、RR、MV、VT。结果两组麻醉效果相同,产生的并发症也无显著性差异(P>0.05)。罗比卡因组对抬头肌的影响显著弱于布比卡因组(P<0.01)。两组HR显著升高(P<0.05),SBP、DBP、MBP、在T1～T5时有显著升高(P<0.05),在T6与T0无显著性差异(P>0.05)。结论以上两组混合液在颈浅及颈深神经丛阻滞均能产生较好的麻醉效果。0.5%罗比卡因和1%利多卡因由于运动神经较弱,更适合颈神经丛阻滞麻醉。更多还原

【Abstract】 Objective To compare the clinical efficacy of lidocaine-ropivacaine and lidocaine-bupivacaine used in cervical plexus block.Methods Fifty patients(ASAⅠ—Ⅱ)undergoing excision of thyrophyma were ran-domly divided into two groups,lidocaine-ropivacaine group (groupI,n=32)and lidocaine-bupivacaine group(groupⅡ,n=18).Patients received superficial cervical block with ropivacaine0.5%and lidocaine1%in group I or bupivacaine0.5%and lidocaine1%10ml in groupⅡ.Deep cervical plexus block was performed with ropi-vacaine0.5%and lidocaine1%in group I or bupivacaine0.5%and lidocaine1%6ml in groupⅡ.The efficacy of anesthesia and the possible complications of cervical plexus block were recorded.HR,SBP,DBP,MAP,SpO 2 ,RR,Mv and V T during operation were recorded as well.Result s There was no significant difference be-tween group I and groupⅡabout the efficacy of anesthesia and the complications.But the motor block of cer-vical muslces in group I was significantly weaker than that in groupⅡ(P<0.01).HR,SBP,DBPand MAP in-creased significantly after cervical plexus block.SBP,DBP and MAP recovered when the operation completed.There were no significant changes in SpO 2 ,RR,M V and V T (P>0.05).There was no significant difference be-tween group I and groupⅡin HR,SBP,DBP,MAP,SpO 2 ,RR,M V and V T (P>0.05).Conclusions Both lido-caine combined with ropivacaine and lidocaine combined with bupivacaine produce a good cervical plexus block.Lidocaine combined with ropivacaine is more suitable for cervical plexus block due to its less motor block.更多还原