【摘要】 目的探讨子宫切除术患者氯普鲁卡因混合罗哌卡因用于硬膜外麻醉的效果。方法拟行子宫切除术患者60例,随机分为R、C₁-R、C₁-R₁、C₂-R₁四组（n=15）,硬膜外分别给予0.75%罗哌卡因、1%氯普鲁卡因+0.75%罗哌卡因、1%氯普鲁卡因+0.5%罗哌卡因、1.5%氯普鲁卡因+0.5%罗哌卡因。记录感觉阻滞最高平面、运动阻滞分级及感觉、运动阻滞起效时间、持续时间、术中辅助用药及不良反应。结果与R组比较,其它三组感觉阻滞的起效时间、达最高平面的时间、BromageⅠ、Ⅱ级的起效时间均缩短,C₁-R₁、C₂-R₁组感觉阻滞持续时间、运动阻滞的持续时间缩短,C₁-R组BromageⅢ级的起效时间缩短,C₁-R组术中低血压发生率升高,内脏牵拉痛发生率降低（P＜0.05）。结论子宫切除术患者1%或1.5%氯普鲁卡因可增强0.5%%罗哌卡因硬膜外麻醉的效果。更多还原

【Abstract】 Objective To assess the efficacy of the mixtures of different concentrations of ropivacaine（R） and chloroprocaine（C）for epidural anesthesia in patients undergoing hysterectomy.Methods Sixty ASAⅠorⅡpatients aged 27-56 weighing 45-75 kg undergoing elective hysterectomy were randomly divided into 4 groups（n= 15 each）;groupⅠ0.75% R alone;groupⅡ0.5% R-1% C;groupⅢ0.5% R-1.5% C and groupⅣ0.75% R+1% C.The epidural catheter was placed at L_2,3interspace and advanced 3.5 cm into the epidural space in cephalad direction.A total of 22 ml of epidural solution was injected in each group.The onset time,block height and duration of sensory block and the onset time,degree and duration of motor block（using Bromage scale）were assessed.The use of supplementary drugs（ketamine and ephedrine）and side effects were recorded.Results The onset time of sensory and motor block was significantly shorter in groupⅡ,ⅢandⅣthan in groupⅠ（0.75% R alone）.The duration of sensory and motor block was significantly shorter in groupⅡandⅢthan in groupⅠandⅣ.The incidence of hypotension was significantly increased but the incidence of discomfort produced by traction on the viscera during operation was reduced in groupⅣas compared with groupⅠ.Conclusion The anesthetic efficacy of epidural 0.5% ropivacaine is significantly enhanced when mixed with 1.0% or 1.5% chloroprocaine.更多还原