【摘要】 目的 :观察罗哌卡因连续硬膜外麻醉下经尿道前列腺汽化术麻醉的效果及心血管反应 ,并与利多卡因和丁卡因的混合液进行比较。方法 :选择ASA1 2级前列腺增生的择期手术患者 40例 ,随机分为两组 ,Ⅰ组为对照组 (N=2 0 ) ,Ⅱ组为观察组 (N =2 0 )。在L2 3 行连续硬膜外穿刺置管成功后 ,Ⅰ组注入 2 %利多卡因 3ml试验量 ,平面出现后根据病人情况追加注入混合液 5～ 15ml,分别观察病人感觉阻滞平面出现的时间 ,最高感觉阻滞平面 ,运动阻滞评定 ,麻醉质量评定及血流动力学变化。结果 :罗哌卡因的最大阻滞时间比混合液长 ,而运动阻滞明显弱于混合液 ,对心血管的影响比混合液轻。结论 :低浓度罗哌卡因作边续硬膜外麻醉用于经尿道前列腺汽化术麻醉时阻滞完善、循环稳定、安全 ,利于高危病人平稳渡过手术期更多还原

【Abstract】 Objective: To study the effect of continous epidural anesthesia with ropivacaine on transurethral vaporization prostatectomy and its cardiovascular reaction.Methods: Forty patients,ASA class Ⅰ Ⅱ,undergoing elective prostatic huperplasia surgery,were devided randomly into control group(groupⅠ)and study group(group Ⅱ).A trial dose was given via epidural cathater after an epidural needle was introduced into the L 2 3 interspace,then an additional dose was given according to the extending of paine.In group Ⅰ,trial dose was 2% lidocaine 3 ml,additional dise was the mixture of lidocaine and tetracine 5～10 ml;In group Ⅱ,0.2% ropvacine 10 ml and 5～10 respectively.The time of appearing blockade,the maximum paine to blockade,motor blockade assessment,anesthesia quality assessment and the hemodynamics change were observed respectively.Results: The time to maximum spread of anesthesia in group Ⅱ was longer than group Ⅰ was longer than group Ⅰ,while the effect of motor blockade was statistically weaker than groupⅠ.The effect on cardiovascular of group Ⅱwas less than group Ⅰ.Conclusion: Epidural anesthesia with low concentration of ropivacaine is effective and safe on transurethral vaporization prostatectomy.更多还原