0.5%布比卡因硬膜外与0.75%罗比卡因硬膜外用于下肢骨科手术的比较

S. Shaikh, K. Rohini
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引用次数: 5

摘要

硬膜外阻滞正成为现代麻醉学中最有用和最通用的手术之一。布比卡因是一种长效酰胺类局部麻醉剂,多年来被广泛应用。然而,它与许多副作用有关,如中枢神经系统(CNS)毒性和心脏毒性。罗哌卡因是印度新近引进的长效酰胺局部麻醉药物,已被开发为布比卡因的可能替代品。它的亲脂性比布比卡因低,因此与中枢神经系统和心脏毒性的潜在降低有关。目的:比较0.5%布比卡因和0.75%罗比卡因在下肢手术硬膜外麻醉中产生感觉阻滞的起效时间和感觉及运动阻滞的持续时间。方法将60例年龄18 ~ 60岁,ASA 1 ~ 2级,接受各种下肢手术的患者随机分为两组,每组30例。A组应用0.75%罗哌卡因15ml, B组应用0.5%布比卡因15ml。观察T10针刺消失时间、运动阻滞强度、感觉和运动阻滞持续时间及血流动力学变化。两种药物的感觉阻滞起效时间和持续时间相当。0.5%布比卡因比0.75%罗比卡因产生的运动阻滞强度更大,持续时间更长。两种药物在血流动力学变化方面具有可比性。结论0.75%罗哌卡因硬膜外麻醉可替代0.5%布比卡因在下肢骨科手术中安全使用。
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Comparison Of Epidural Bupivacaine 0.5% With Epidural Ropivacaine 0.75% For Lower Limb Orthopedic Procedures
Epidural blockade is becoming one of the most useful and versatile procedures in modern anesthesiology. Bupivacaine is a long acting amide local anaesthetic which is widely used since many years. However, it is associated with a number of side effects like Central Nervous System (CNS) toxicity and cardiotoxicity. Ropivacaine is a newly introduced long acting amide local anaesthetic drug in India which has been developed as a possible alternative to Bupivacaine. It has a lower lipophilicity than bupivacaine and hence associated with a decreased potential for CNS and cardiotoxicity. AimsThe aim of the study was to compare the time of onset of sensory block and duration of sensory and motor blockade of epidural anaesthesia produced by bupivacaine 0.5% and ropivacaine 0.75% for lower limb surgery.Methods60 patients, aged between 18-60 years, ASA 1 and 2, undergoing various lower limb surgeries were randomly allocated to 2 groups of 30 each. Group A received 15ml of 0.75% ropivacaine and group B received 15 ml of 0.5% bupivacaine epidurally. The time for loss of pinprick at T10, intensity of motor block, duration of sensory and motor block and hemodynamic changes were assessed.Results1. The time of onset and duration of sensory block was comparable for both the drugs.2. Bupivacaine 0.5% produced more intensity and longer duration of motor block than ropivacaine 0.75%3. Both the drugs were comparable with respect to hemodynamic changes.ConclusionEpidural ropivacaine 0.75% can be safely used as a possible alternative to bupivacaine 0.5% in lower limb orthopedic procedures.
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