CAJ | 학술논문

目的比较盐酸左旋布比卡因(Levobupivacaine hydrochloride)和盐酸利多卡因(Lidocaine hydrochloride)作为高位硬膜外阻滞用于乳腺手术对血压(BP)、心率(HR)及血氧饱和度(SpO2)的影响.方法随机将美国麻醉医师协会(ASA)Ⅰ~Ⅱ级乳腺癌患者117例分为盐酸左旋布比卡因组57例,盐酸利多卡因组60例.2组麻醉前用药和麻醉操作相同,均硬膜外腔注入相应药物,分别于硬膜外麻醉注药前,注药后20 min、45 min 记录 BP、HR 及 SpO2各参数值.结果盐酸利多卡因组患者硬膜外注药后20 min 和45 min 时 BP、SpO2均有不同程度的下降,HR 增快,与硬膜外注药前相比,有显著性差异(P<0.01);盐酸左旋布比卡因组患者硬膜外注药前后 HR、BP 及 SpO2无明显变化.结论低浓度盐酸左旋布比卡因血浆游离浓度低,用于乳腺手术高位硬膜外阻滞,具有对中枢神经系统毒性低,心脏毒性小,维持时间长和对呼吸循环影响小等优点,是较为可取的一种麻醉方法.
목적비교염산좌선포비잡인(Levobupivacaine hydrochloride)화염산리다잡인(Lidocaine hydrochloride)작위고위경막외조체용우유선수술대혈압(BP)、심솔(HR)급혈양포화도(SpO2)적영향.방법수궤장미국마취의사협회(ASA)Ⅰ~Ⅱ급유선암환자117례분위염산좌선포비잡인조57례,염산리다잡인조60례.2조마취전용약화마취조작상동,균경막외강주입상응약물,분별우경막외마취주약전,주약후20 min、45 min 기록 BP、HR 급 SpO2각삼수치.결과염산리다잡인조환자경막외주약후20 min 화45 min 시 BP、SpO2균유불동정도적하강,HR 증쾌,여경막외주약전상비,유현저성차이(P<0.01);염산좌선포비잡인조환자경막외주약전후 HR、BP 급 SpO2무명현변화.결론저농도염산좌선포비잡인혈장유리농도저,용우유선수술고위경막외조체,구유대중추신경계통독성저,심장독성소,유지시간장화대호흡순배영향소등우점,시교위가취적일충마취방법.
Objectives To investigate the different effect of radical operation of breast cancer patients on blood pressure(BP), heart rate(HR) and oxygen saturation(SpO2) by continuous epidural anesthesia(CEA) treated with levobupivacaine hydrochloride and lidocaine hydrochloride respectively. Methods According to American Society of anesthesiologists ( ASA ) Ⅰ and Ⅱ , 117 cases of patients with breast cancer were divided into levobupivacaine hydrochloride group (57 cases), lidocaine hydrochloride group (60 cases). two groups of premedication and anesthesia operation were same, epidural injection of drugs in epidural anesthesia, and the parameters of BP, HR and SpO2 were recorded before operation, 20min and 45min after CEA. Results BP and SpO2 of patients in Group of lidocaine hydrochloride declined and HT increased significantly at 20min and 45min after CEA, while those were not changed in patients in Group of levobupivacaine hydrochloride. Conclusion Levobupivacaine hydrochloride at low concentration by CEA were adventangeous for radical operation of breast cancer and reduced the side-effects on nervous system, cardiovascular system and respiratory system.