使用 0.5% 布比卡因和 0.5% 左布比卡因进行头皮阻滞以插入 Mayfield 对血流动力学反应和术后镇痛效果的临床比较研究

Kalapala Ramesh, Bandrapalli Emeema, K. I. Priyadarshini, Chandrasekhar Vallepalli, Madhulika Yeluru
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摘要

研究目的本研究旨在比较 0.5%盐酸布比卡因和 0.5%左布比卡因用于头皮阻滞时的血流动力学反应、疗效以及开颅手术 Mayfield 插入术后的额外镇痛需求。方法:将 60 名接受择期开颅手术的美国麻醉医师协会体能状态Ⅰ级和Ⅱ级患者随机分为两组,B 组(30 人)接受 0.5% 盐酸布比卡因 25 毫升头皮阻滞,L 组(30 人)在插入 Mayfield 前 5 分钟接受 0.5% 左布比卡因 25 毫升头皮阻滞。记录不同时间点的平均动脉压(MAP)、脉搏、疼痛评分(VAS 评分)、术中和术后额外镇痛剂需求。结果两组患者在所有时间点插入 Mayfield 期间和之后的脉搏率、平均动脉压均保持稳定。结论用于头皮阻滞的布比卡因和左旋布比卡因在减弱插入 Mayfield 期间的血流动力学反应方面效果相同。左旋布比卡因毒性较低,可作为头皮阻滞的安全替代方案。
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A CLINICAL COMPARATIVE STUDY OF SCALP BLOCK WITH 0.5% BUPIVACAINE VERSUS LEVOBUPIVACAINE 0.5% FOR MAYFIELD INSERTION ON HAEMODYNAMIC RESPONSE AND EFFICACIES OF POSTOPERATIVE ANALGESIA
Objective: Present study was performed to compare the effectiveness of 0.5% bupivacaine hydrochloride and 0.5% levobupivacaine for scalp block on the haemodynamic response, efficacy and additional analgesic requirement of these drugs in the post operative period during Mayfield insertion for craniotomy. Methods: 60 patients of American society of anaesthesiologists physical status Ⅰ and Ⅱ who underwent elective craniotomies were randomly divided into two groups Group B (n=30) who received scalp block with 0.5% bupivacaine hydrochloride 25 ml, Group L (n=30) received 25 ml of 0.5% levobupivacaine 5 min prior to Mayfield insertion. Mean arterial pressure (MAP), pulse rate, pain score (VAS score), additional intraoperative and postoperative analgesic requirement were recorded at different time points. Results: Pulse rate, mean arterial pressure were stable during and after Mayfield insertion in both groups at all time points. Conclusion: Both bupivacaine and levobupivacaine for scalp block are equally effective in attenuating haemoynamic responses during Mayfield insertion. Levobupivacaine being less toxic can be a safe alternative for scalp block.
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