甲磺酸罗哌卡因与盐酸罗哌卡因用于腋路臂丛神经阻滞的对比研究(1)
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[摘要] 目的：比较甲磺酸罗哌卡因与盐酸罗哌卡因用于腋路臂丛神经阻滞的有效性和安全性。方法：48例ASAⅠ～Ⅱ级择期上肢手术患者随机分为0.5%盐酸罗哌卡因组(A组)和0.596%甲磺酸罗哌卡因组(B组)。每组24例，两组患者均行腋路臂丛神经阻滞，观察感觉与运动神经阻滞起效时间、持续时间及不良反应，评价麻醉效果。结果：在感觉与运动神经阻滞的起效时间、持续时间及不良反应方面，0.596%甲磺酸罗哌卡因与0.5%盐酸罗哌卡因未见明显差异。结论：0.596%甲磺酸罗哌卡因与0.5%盐酸罗哌卡因应用于腋路臂丛神经阻滞，具有相似的有效性和安全性。
[关键词] 甲磺酸罗哌卡因；盐酸罗哌卡因；腋路臂丛神经阻滞
[中图分类号] R971.2 [文献标识码]B[文章编号]1673-7211(2009)01(a)-067-02
Comparative study of Ropivacaine Mesylate and Ropivacaine Hydrochloride for axillary brachial plexus block
WANG Wei-hua, ZHANG Qing, HOU Xi-long
(Department of Anesthesiology, Dalian Second People＇s Hospital, Dalian116011, China)
[Abstract] Objective: To compare the efficacy and safety of Ropivacaine Mesylate and Ropivacaine Hydrochloride for axillary brachial plexus block. Methods: 48 ASAⅠorⅡpatients scheduled for upper extremity surgery were randomly divided into two groups: 0.5% Ropivacaine Hydrochloride group (group A) and 0.596% Ropivacaine Mesylate group (group B), with 24 patients in each group. All patients were performed with axillary brachial plexus block. Then the initiating time, lasting time of sensory and motor block as well as the adverse reaction were observed, and the anesthetic effect was evaluated. Results: No significant difference of the initiating or lasting time, or even the adverse reaction of sensory and motor block was observed between the two groups. Conclusion: 0.5% Ropivacaine Hydrochloride and 0.596% Ropivacaine Mesylatehave similar efficacy and safety in the application of axillary brachial plexus block.
[Key words] Ropivacaine Mesylate; Ropivacaine Hydrochloride; Axillary brachial plexus block
盐酸罗哌卡因是一种长效酰胺类局部麻醉药。与布比卡因相比，其中枢神经系统和心脏毒性较小[1,2]，是一种较为理想的局麻药。甲磺酸罗哌卡因是将盐酸罗哌卡因的盐酸根改为甲磺酸根后的一种国产新型酰胺类局麻药[3]。有资料[4]显示，0.894%甲磺酸罗哌卡因与等效浓度的0.75%盐酸罗哌卡因用于腰段硬膜外阻滞的效应基本相同。本研究拟通过随机对照试验方案比较甲磺酸罗哌卡因和盐酸罗哌卡因用于腋路臂丛神经阻滞的临床效果和安全性。
1 资料与方法
1.1 一般资料
择期上肢手术患者48例，ASAⅠ～Ⅱ级，年龄17～59岁，体重46～92 kg。其中，前臂外伤22例，手外伤26例。患者心、脑、肺功能均无异常。
1.2 麻醉方法
随机将患者分为两组，A组：0.5%盐酸罗哌卡因组(n=24)，1%盐酸罗哌卡因(英国阿斯利康公司，产品批号：IK1607)15 ml+生理盐水15 ml；B组：0.596%甲磺酸罗哌卡因组(n=24)，0.894%甲磺酸罗哌卡因(江苏恩华药业公司，产品批号：20080303)20 ml+生理盐水10 ml。两组患者术前用药均为地西泮10 mg，阿托品0.5 mg。患者入室后，常规监测心率(HR)、血压(BP)、心电图(ECG)和动脉血氧饱和度(SpO2) ......
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