【摘要】 目的观察比较布比卡因在肾移植术和肾功能正常病人中的麻醉效果。方法选择近两年ASAⅡ-Ⅲ级肾移植患者136例(GroupT),选择ASAⅠ-Ⅱ肾功能正常的拟行下腹部手术的患者130例,作为对照组(GroupC)。两组病人在T11-12和L3-4间隙作硬膜外腔穿刺并置留导管。先上管注射2%利多卡因3ml作为实验剂量,5分钟后给予0.75%布比卡因10ml。观察麻醉阻滞效果。结果T组的感觉阻滞起效时间、感觉阻滞达峰时间、运动阻滞达峰时间明显长于C组(P<0.01),而感觉阻滞持续时间和运动阻滞维持时间则显著短于C组(P<0.01)。两组间麻醉感觉阻滞平面的差异不大(P>0.05)。结论布比卡因等局麻药应用于肾移植术硬膜外麻醉中,起效较肾功能正常患者慢,维持时间短。更多还原

【Abstract】 Objective To observe and compare the effect of bupivacaine epidurally used for renal transplantation.Methods 130 selected ASAⅡ-Ⅲ patients underwent renal transplantation in the last two years were enrolled as Group Test(Group T),another 130 patients with normal renal function underwent subabdominal surgery were selected as Group Control(Group C).All patients were inserted epidural catheters at the interspace of TⅣ/TⅤ and TⅤ/TⅥ respectively before surgery in the operating room.3 ml 2%lidocaine was infused through upper catheters.5 min later,10 ml 0.75%bupivacaine was infused. Onset time for sensory block, time for maximum cephaled, spread of sensory block,degree of motor block and duration of sensory and motor block was measured in all patients.Results According to the statistical datum, the onset time for sensory block, time for maximum cephaled and motor block were obviously slower in Group T than that in Group C(P<0.01);duration of sensory and motor block is shorter in Group T than that in Group C(P<0.01).But spread of sensory block was similarly(P>0.05)in these two groups.Conclusion As a kind of local anesthetics,bupivacaine used for epidural anesthesia produces delayed onset and shorten sensory and motor block in CRF patients than those in normal renal function patients.更多还原