【摘要】 目的观察0.5%罗哌卡因、布比卡因10 mg蛛网膜下腔阻滞对感觉、运动神经的阻滞效果及对血流动力学影响。方法随机选取择期行下肢、下腹或肛肠手术病人48例,ASAⅠ~Ⅱ级,分为布比卡因组(BP组)和罗哌卡因组(RP组),于L2~3、L3~4间隙行腰硬联合穿刺,蛛网膜下腔穿刺成功后于蛛网膜下腔分别注入0.5%的布比卡因或罗哌卡因10 mg,之后于硬膜外腔向头侧置管4 cm以备蛛网膜下腔阻滞不能满足手术需要时追加局麻药。观查并记录感觉阻滞平面,运动神经阻滞程度及血流动力学变化。结果两组病人血流动力学稳定,麻醉平面均能满足手术要求。BP组感觉平面高于RP组,RP组术后下肢运动恢复快于BP组。结论0.5%罗哌卡因、布比卡因10 mg用于腰硬联合麻醉可作为肛肠、部分下腹、下肢手术的麻醉选择;其中罗哌卡因术后下肢运动恢复快,较快恢复自主排尿为其优点。更多还原

【Abstract】 Objective To investigate the differences of 0.5% bupivacaine or ropivacaine 10 mg in spinal anaesthesia on sensory,motor block and hemodynamics.Methods 48 ASA I-II patients undergoing elective lower limbs and subabdominal or anorectal operation,were randomly assigned to bupivacaine(BP) group and ropivacaine(RP)group,using combined spinal-epidural anaesthesia at L2-3 or L3-4 space,0.5% bupivacaine or ropivacaine 10 mg were injected into subarachnoind respectively,then epidural catheter was inserted cephalad 4 cm into the epidural space.The extent of sensory and motor block and the changes of hemodynamics were recorded.Results The hemodynamics of the two groups were all steady.The extent of sensory of two groups contented the require of operation.The maximum extent of sensory block of BP group were higher than that of RP group.The durations of motor block of RP group were shorter than that of BP group.Conclusion 0.5% bupivacaine or ropivacaine 10 mg in spinal anaesthesia may be used for lower limbs and part of subabdominal and anorectal operation;the durations of motor block of ropivacaine is shorter and independent emiction resumes rapidly.更多还原