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1、0.75%罗哌卡因用于小儿蛛网膜下腔阻滞中的临床研究【摘要】目的 探讨0.75%罗哌卡因用于小儿蛛网膜下腔阻滞的合适剂量。方法 选择ASAI-Ⅱ级择期手术的小儿患者60例,随机分为三组,每组20例。A组0.75%罗哌卡因2ml(按每厘米椎管长0.15mg给药)、B组0.75%罗哌卡因2ml(按每厘米椎管长0.3mg给药)、C组0.5%布比卡因2ml(按每厘米椎管长0.15mg给药)。用药后观察最高感觉阻滞平面等蛛网膜下腔阻滞运动和感觉参数、监测不同时间段的MAP、HR值和不良反应和并发症。结果 A组最高阻滞平面、T10感
2、觉平面阻滞持续时间、平面固定时间、运动起效时间、运动恢复时间,与C组比较,差异有统计学意义(F分别=0.16、7.03、0.57、19.23、1.17,P均<0.05),与B组比较,差异有统计学意义(F分别=0.21、6.78、0.78、17.98、1.23,P均<0.05);A组下肢运动阻滞程度弱于C组,差异有统计学意义(χ2分别=40.83、21.16、10.42,P均<0.05),与B组比较,差异有统计学意义(χ2分别=36.01、21.16、9.60,P均<0.05);B组运动恢复快于C组,差异有统计学意义(F=
3、1.23,P<0.05);B组感觉阻滞起效时间与A组、C组比较,差异无统计学意义(F分别=4.13、4.54,P均>0.05)。结论 0.75%罗哌卡因每厘米椎长0.3mg用于小儿脊麻能达到安全麻醉;而0.75%罗哌卡因每厘米椎长0.15mg用于小儿脊麻,运动、感觉阻滞较布比卡因差。9【关键词】罗哌卡因布比卡因小儿蛛网膜下腔阻滞[Abstract]ObjectiveToobservetheeffectsofdifferentdosesofropivacaineforspinalanesthesia,andcomparew
4、ithbupivacaine.MethodsSixtyASAI-Ⅱchildren,scheduledforlowabdominalsurgeryandlowerlimboperationswererandomlyallocatedtothreegroups,groupAwasreceived0.75%ropivacaine0.15mg/spinallength,groupBwasreceived0.75%ropivacaine0.3mg/spinallength,groupCwasreceived0.5%bupivac
5、aine0.15mg/spinallength.Theonsettimeandduration,theupperlevelofanesthesia,degreeofmotorblockwererecorded,thevitalsignsofthekidswererecordedduringthesurgery.ResultsTherewerestatisticdifferencesintheupperlevelofanesthesia,durationtimeofT10sensoryblock,thefixedtimeo
6、fsensoryblock,onsettimeofmotorblockandthemotorrecuperationtimebetweengroupAandgroupC(F=0.16,7.03,0.57,19.23,1.17,P<0.05),andgroupB(F=0.21,6.78,0.78,17.98,1.23,P<0.05).ThedegreeofthemotorblockofgroupAwasweakerthangroupC(χ2=40.83,21.16,10.42,P<0.05),andgroupB(χ2=36
7、.01,21.16,9.60,P<0.05).ThemotorrecuperationtimeofgroupBwasfasterthangroupC(F=1.23,P<0.05).Therewereno9differencesinonsettimeofsensoryblockbetweengroupBandtheother2groups(F=4.13,4.54,P>0.05,).Conclusions0.3mg/spinallength0.75%ropivacaineissafeanesthesiaforchildren
8、;0.15mg/spinallengthropivacaineisaweakermotorblockandsensoryblockthanbupivacaine.[Keywords]ropivacaine; bupivacaine; children; spinalanesthesia罗哌卡因化学结构与布比卡因相似,