Hartmannsgruber M W, Silverman D G, Halaszynski T M, Bobart V, Brull S J, Wilkerson C, Loepke A W, Atanassoff P G
Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut 06250-8051, USA.
Anesth Analg. 1999 Sep;89(3):727-31. doi: 10.1097/00000539-199909000-00037.
A longer acting local anesthetic such as ropivacaine may offer advantages over lidocaine for IV regional anesthesia (IVRA). The objective of this investigation was to determine whether the use of ropivacaine improves the quality and duration of IVRA. In a randomized, double cross-over design, 10 volunteers received lidocaine 0.5% or ropivacaine 0.2% for IVRA of the upper extremity on two separate days with a standard double-cuff technique. Sensation to pinprick, response to tetanic stimuli, and tourniquet pain were assessed on a 0-10 verbal numeric score scale at 5-min intervals throughout the period of tourniquet inflation. Motor function was evaluated by grip strength. After release of the second (distal) cuff, pinprick sensation, motor strength, and systemic side effects were evaluated at 3, 10, and 30 min. No significant differences were observed for onset times of anesthesia and times to proximal (38 +/- 3 and 36 +/- 3 min) or distal (34 +/- 13 and 36 +/- 13 min) tourniquet release after the administration of ropivacaine and lidocaine, respectively. However, postdeflation hypoalgesia and motor blockade were prolonged with ropivacaine, and postdeflation light-headedness, tinnitus, and drowsiness were more prominent with lidocaine. We conclude that ropivacaine may be an alternative to lidocaine for IVRA. It may result in prolonged analgesia and fewer side effects after tourniquet release.
In this study, volunteers received lidocaine 0.5% or ropivacaine 0.2% for IV regional anesthesia on two study days. Ropivacaine and lidocaine provided similar surgical conditions. However, after release of the distal tourniquet, prolonged sensory blockade and fewer central nervous system side effects were observed with ropivacaine.
长效局部麻醉药如罗哌卡因在静脉区域麻醉（IVRA）中可能比利多卡因更具优势。本研究的目的是确定使用罗哌卡因是否能改善IVRA的质量和持续时间。在一项随机、双交叉设计中，10名志愿者在两个不同的日子里，采用标准双袖带技术，接受0.5%利多卡因或0.2%罗哌卡因进行上肢IVRA。在整个止血带充气期间，每隔5分钟用0至10的语言数字评分量表评估针刺感觉、对强直刺激的反应和止血带疼痛。通过握力评估运动功能。在松开第二个（远端）袖带后，在3、10和30分钟时评估针刺感觉、运动强度和全身副作用。分别给予罗哌卡因和利多卡因后，麻醉起效时间以及近端（38±3和36±3分钟）或远端（34±13和36±13分钟）止血带松开时间未观察到显著差异。然而，罗哌卡因使放气后痛觉减退和运动阻滞时间延长，而利多卡因使放气后头晕、耳鸣和嗜睡更为明显。我们得出结论，罗哌卡因可能是IVRA中利多卡因的替代药物。它可能导致放气后镇痛时间延长且副作用更少。
在本研究中，志愿者在两个研究日接受0.5%利多卡因或0.2%罗哌卡因进行静脉区域麻醉。罗哌卡因和利多卡因提供了相似的手术条件。然而，在松开远端止血带后，罗哌卡因观察到感觉阻滞时间延长且中枢神经系统副作用更少。
