鞘内应用重比重及等比重左旋布比卡因在泌尿外科手术中的比较。
Comparison of intrathecal hyperbaric and isobaric levobupivacaine in urological surgery.
机构信息
Department of Anesthesia and Resuscitation, Gulhane Military Medical Academy Haydarpasa Training Hospital, Usküdar, Istanbul, Turkey.
出版信息
Minerva Anestesiol. 2010 Jan;76(1):24-8. Epub 2009 Nov 24.
AIM
The aim of our study was to compare the efficacy of hyperbaric and isobaric solutions of intrathecal levobupivacaine for transurethral endoscopic surgery.
METHODS
Urological patients who were scheduled for elective surgery under spinal anesthesia were enrolled. The heavy group received 13.5 mg of hyperbaric levobupivacaine, while the plain group received 13.5 mg isobaric levobupivacaine, both intrathecally in a 3 mL total volume. Sensory and motor block, hemodynamic parameters, pain scores, adverse effects, and analgesic requirements of the patients were recorded.
RESULTS
Values of the time to onset of T10 sensory block, time to maximum sensory block, regression to L1 dermatome, time to motor block Bromage 1, time to motor block Bromage 3, and time to the end of motor block (Bromage 0) were all smaller in group 1 than in group 2 (all P values <0.05). No difference between the groups with regard to time to two segment regression of sensory block could be detected. The mean duration of initial analgesic effect, extent of maximal block, and side effects were the same in both groups (P>0.05).
CONCLUSIONS
We concluded that the clinical efficacy of hyperbaric levobupivacaine was superior to the isobaric form in spinal anesthesia for transurethral resection.
目的
本研究旨在比较鞘内给予重比重和等比重左旋布比卡因用于经尿道内镜手术的效果。
方法
选择择期行椎管内麻醉下手术的泌尿科患者。重比重组鞘内给予 13.5mg 重比重左旋布比卡因,等比重组鞘内给予 13.5mg 等比重左旋布比卡因,均为 3mL 总量。记录患者的感觉和运动阻滞、血流动力学参数、疼痛评分、不良反应和镇痛需求。
结果
T10 感觉阻滞起效时间、最大感觉阻滞时间、回归至 L1 皮区时间、运动阻滞 Bromage 1 时间、运动阻滞 Bromage 3 时间和运动阻滞结束时间(Bromage 0)在 1 组均短于 2 组(均 P 值<0.05)。两组间感觉阻滞两个节段的回归时间无差异。两组初始镇痛效果持续时间、最大阻滞程度和不良反应相同(P>0.05)。
结论
我们得出结论,在经尿道前列腺切除术的椎管内麻醉中,重比重左旋布比卡因的临床效果优于等比重制剂。