耐乐品与布比卡因用于低位硬膜外阻滞的比较

时间：2023-03-19 15:21:25 医学毕业论文我要投稿

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作者：吴庭英, 莫劲思, 罗建刚

【关键词】 ,,硬膜外

摘要：目的：比较0.5% 耐乐品和0.5% 布比卡因对低位硬膜外麻醉的临床效果和安全性。方法：40例在硬膜外麻下施行下腹部手术的妇产科患者(ASAⅠ ～Ⅱ 级) 随机分为二组, 耐乐品组:05% 耐乐品(n= 20 例) ; 布比卡因组: 05% 布比卡因(n= 20 例)。取L 2～ 3行硬膜外穿刺, 注入首次剂量耐乐品或布比卡因8～10ml, 总量不超过20m l。观察两组病人用药总量、感觉阻滞范围和起效时间和副作用。结果：两组病人用药总量、感觉阻滞范围和起效时间无明显差异。耐乐品组止痛时间、肌松效果和感觉运动阻滞分离较布比卡因组强, 耐乐品组低血压发生率较布必卡因高。结论：耐乐品组止痛时间、肌松效果和感觉运动阻滞分离较布比卡因组强。0.5% 耐乐品比0.5% 布比卡因在低位硬外麻中效果好。

　　关键词：布比卡因；耐乐品；麻醉；硬膜外

　　Comparison between Naropin and Bupivacaine Used in Lower Level Epidural Obstruction

　　Abstract： Objective: To compare 0.5% Naropin with 0.5% Bupivacaine in clinical effect and safe for epidural anesthesia. Method: 40 cases of patients (ASA I II grades) who are operated on lower abdomen under epidural anesthesia are divided into two groups; Naropin group: 0.5% Naropin (n = 20 cases); Bupivacaine group: 0.5% Bupivacaine (n = 20 cases). Taking L2～3 lines epidural puncture to be initially injected for Naropine or Bupivacaine 8～10 ml, gross dosage doesn’t exceed 20 ml. To observe two groups of patients who use gross medicine dosage, feeling obstruction scope, effect of initial taking medicine and side effect. Result: The difference between two groups using gross medicine dosage, feeling obstruction scope, effect of initial taking medicine is not clear; The Naropin group stopping pain time, muscle relaxing effect and feeling movement obstruction separation are relatively stronger than that of Bupivacaine group; The low blood pressure rate for Naropin is higher than that of Bupivacaine group. Conclusion: The 0.5% Naropin is better than 0.5% Bupivacaine in low level of epidural anesthesia. The Naropin group stopping pain time, muscle relaxing effect and feeling movement obstruction separation are relatively stronger than that of Bupivacaine group.

　　Key words: Bupivacaine； Naropin； Anesthesia； Epidural

　　我们选择40 例妇科手术病人, 通过对0.5% 耐乐品和0.5% 布比卡因低位硬膜外麻醉的效果、阻滞的特性及安全性进行比较，观察耐乐品在低位硬膜外麻醉的临床效果。

　　1 资料与方法

　　1.1 病例选择：40例拟在硬膜外阻滞下施行下腹部、盆腔部择期手术的妇产科患者年龄（20 ～60 岁,ASA Ⅰ～ Ⅱ）随机分为耐乐品组(研究组) 和布比卡因(对照组) ,每组各20例。

　　1.2 麻醉方法：术前用药均为阿托品0.5mg、鲁米那100mg 肌肉注射。手术前开放静脉,输入平衡液,建立心电图、血压和脉搏和血氧饱和度(SpO2 )的监测。侧卧位下于L2～3 或L3～4 间隙行硬膜外穿刺置管,分别注入首次量0.5%耐乐品5ml 或0.5 %布比卡因5ml ,5min 后无全脊麻征象, 再给予0.5%耐乐品10ml 或0.5 %布比卡因10ml。术中可根据情况追加用药，总量不超过20ml。

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