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耐樂品與布比卡因用于低位硬膜外阻滯的比較

時(shí)間:2023-03-19 15:21:25 醫(yī)學(xué)畢業(yè)論文 我要投稿
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耐樂品與布比卡因用于低位硬膜外阻滯的比較

耐樂品與布比卡因用于低位硬膜外阻滯的比較

作者:吳庭英, 莫勁思, 羅建剛

【關(guān)鍵詞】 ,,硬膜外

摘 要:目的:比較0.5% 耐樂品和0.5% 布比卡因?qū)Φ臀挥材ね饴樽淼呐R床效果和安全性。方法:40例在硬膜外麻下施行下腹部手術(shù)的婦產(chǎn)科患者(ASAⅠ ~Ⅱ 級) 隨機(jī)分為二組, 耐樂品組:05% 耐樂品(n= 20 例) ; 布比卡因組: 05% 布比卡因(n= 20 例)。取L 2~ 3行硬膜外穿刺, 注入首次劑量耐樂品或布比卡因8~10ml, 總量不超過20m l。觀察兩組病人用藥總量、感覺阻滯范圍和起效時(shí)間和副作用。結(jié)果:兩組病人用藥總量、感覺阻滯范圍和起效時(shí)間無明顯差異。耐樂品組止痛時(shí)間、肌松效果和感覺運(yùn)動阻滯分離較布比卡因組強(qiáng), 耐樂品組 低血壓發(fā)生率較布必卡因高。結(jié)論:耐樂品組止痛時(shí)間、肌松效果和感覺運(yùn)動阻滯分離較布比卡因組強(qiáng)。0.5% 耐樂品比0.5% 布比卡因在低位硬外麻中效果好。

  關(guān)鍵詞: 布比卡因; 耐樂品; 麻 醉; 硬膜外

  Comparison between Naropin and Bupivacaine Used in Lower Level Epidural Obstruction

  Abstract: Objective: To compare 0.5% Naropin with 0.5% Bupivacaine in clinical effect and safe for epidural anesthesia. Method: 40 cases of patients (ASA I II grades) who are operated on lower abdomen under epidural anesthesia are divided into two groups; Naropin group: 0.5% Naropin (n = 20 cases); Bupivacaine group: 0.5% Bupivacaine (n = 20 cases). Taking L2~3 lines epidural puncture to be initially injected for Naropine or Bupivacaine 8~10 ml, gross dosage doesn’t exceed 20 ml. To observe two groups of patients who use gross medicine dosage, feeling obstruction scope, effect of initial taking medicine and side effect. Result: The difference between two groups using gross medicine dosage, feeling obstruction scope, effect of initial taking medicine is not clear; The Naropin group stopping pain time, muscle relaxing effect and feeling movement obstruction separation are relatively stronger than that of Bupivacaine group; The low blood pressure rate for Naropin is higher than that of Bupivacaine group. Conclusion: The 0.5% Naropin is better than 0.5% Bupivacaine in low level of epidural anesthesia. The Naropin group stopping pain time, muscle relaxing effect and feeling movement obstruction separation are relatively stronger than that of Bupivacaine group.

  Key words: Bupivacaine; Naropin; Anesthesia; Epidural

  我們選擇40 例婦科手術(shù)病人, 通過對0.5% 耐樂品和0.5% 布比卡因低位硬膜外麻醉的效果、阻滯的特性及安全性進(jìn)行比較,觀察耐樂品在低位硬膜外麻醉的臨床效果。

  1 資料與方法

  1.1 病例選擇:40例擬在硬膜外阻滯下施行下腹部、盆腔部擇期手術(shù)的婦產(chǎn)科 患者年齡(20 ~60 歲,ASA Ⅰ~ Ⅱ) 隨機(jī)分為耐樂品組(研究組) 和布比卡因(對照組) ,每組各20例。

  1.2 麻醉方法:術(shù)前用藥均為阿托品0.5mg、魯米那100mg 肌肉注射。手術(shù)前開放靜脈,輸入平衡液,建立心電圖、血壓和脈搏和血氧飽和度(SpO2 )的監(jiān)測。側(cè)臥位下于L2~3 或L3~4 間隙行硬膜外穿刺置管,分別注入首次量0.5%耐樂品5ml 或0.5 %布比卡因5ml ,5min 后無全脊麻征象, 再給予0.5%耐樂品10ml 或0.5 %布比卡因10ml。術(shù)中可根據(jù)情況追加用藥,總量不超過20ml。

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