CAJ | 학술논문

目的：：比较罗哌卡因与左旋布比卡因在腹部手术腰硬联合麻醉中的效果安全性。方法：腰硬联合麻醉的腹部手术患者86例随机分为A、B两组各43例。 A组采用罗哌卡因麻醉、B组采用左旋布比卡因麻醉,比较两组患者麻醉效果、各时间点患者血流动力学变化,及药品不良反应发生情况。结果：两组患者感觉阻滞时间比较,差异无统计学意义(P>0.05),而A组术后运动神经恢复时间显著短于B组(P<0.05),Bromege评分也显著低于B组(P<0.05)。两组患者麻醉阻滞起效后SBP、DBP、HR等指标均较麻醉前显著降低(P<0.05),而麻醉结束后两组收缩压(SBP)、舒张压(DBP)、心率(HR)与麻醉前比较,差异无统计学意义(P>0.05)。术中各时间点两组SBP、DBP、HR等指标比较,差异也无统计学意义(P>0.05)。两组药品不良反应发生率比较,差异无统计学意义(P>0.05)。结论：罗哌卡因与左旋布比卡因对患者感觉神经的阻滞作用相当,对患者血流动力学的影响及药品不良反应发生率也基本相同。而罗哌卡因对于运动神经的阻滞作用较弱,更有利于患者术后早期运动。
목적：：비교라고잡인여좌선포비잡인재복부수술요경연합마취중적효과안전성。방법：요경연합마취적복부수술환자86례수궤분위A、B량조각43례。 A조채용라고잡인마취、B조채용좌선포비잡인마취,비교량조환자마취효과、각시간점환자혈류동역학변화,급약품불량반응발생정황。결과：량조환자감각조체시간비교,차이무통계학의의(P>0.05),이A조술후운동신경회복시간현저단우B조(P<0.05),Bromege평분야현저저우B조(P<0.05)。량조환자마취조체기효후SBP、DBP、HR등지표균교마취전현저강저(P<0.05),이마취결속후량조수축압(SBP)、서장압(DBP)、심솔(HR)여마취전비교,차이무통계학의의(P>0.05)。술중각시간점량조SBP、DBP、HR등지표비교,차이야무통계학의의(P>0.05)。량조약품불량반응발생솔비교,차이무통계학의의(P>0.05)。결론：라고잡인여좌선포비잡인대환자감각신경적조체작용상당,대환자혈류동역학적영향급약품불량반응발생솔야기본상동。이라고잡인대우운동신경적조체작용교약,경유리우환자술후조기운동。
Objective:To compare the efficacy and safety of ropivacaine and bupivacaine in combined spinal epidural anesthesia in abdominal operation. Methods:Totally 86 abdominal operation patients with combined spinal epidural anesthesia were randomly divid-ed into group A and group B with 43 ones in each. Group A was with ropivacaine anesthesia, while group B was with levobupivacaine anesthesia. The anesthesia effect, hemodynamic changes at different time points and adverse drug reactions were compared between the two groups. Results:The duration of sensory block in the two groups was not statistically different (P>0. 05), while the patients in group A had shorter motor nerve recovery time than those in group B (P<0. 05), and Bromege score of group A was significantly lower than that of group B (P<0. 05). After the onset of anesthesia block, all hemodynamic parameters (SBP, DBP and HR) in the two groups were lower than those before the anesthesia (P<0. 05), while at the end of anesthesia, the parameters showed no statistically significant difference from those before the anesthesia (P>0. 05). During the operation, the parameters at different time points in group A had no significant difference from those in group B (P>0. 05). The incidence of adverse drug reaction was not statistically significant between the two groups as well (P>0. 05). Conclusion:Ropivacaine and levobupivacaine show similar blocking effect on the sensory nerve with the same effects on hemodynamics and adverse reactions, however, the blocking effect of ropivacaine on motor nerve is weaker, which is more beneficial to the early exercise of the patients after operation.