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鞘内高压与等压罗哌卡因的对比研究:一项随机对照试验。

Comparative study of intrathecal hyperbaric versus isobaric ropivacaine: A randomized control trial.

作者信息

Gupta Rajni, Bogra Jaishri, Singh Prithvi Kumar, Saxena Sulekha, Chandra Girish, Kushwaha Jitendra Kumar

机构信息

Department of Anaesthesia, King George's Medical University, Lucknow, Uttar Pradesh, India.

出版信息

Saudi J Anaesth. 2013 Jul;7(3):249-53. doi: 10.4103/1658-354X.115326.

Abstract

BACKGROUND

Hyperbaric ropivacaine produce more reliable sensory and motor block, with faster onset, better quality of muscles relaxation than isobaric ropivacaine. So, this study was designed to compare the efficacy of hyperbaric ropivacaine with isobaric ropivacaine in patients undergoing lower abdominal surgery.

METHODS

A randomized controlled double blind study in two groups of patients. group A (n=35) received 3 ml of isobaric ropivacaine 6 mg/ml (18 mg). Group B (n=35) received 3 ml of hyperbaric ropivacaine 6 mg/ml (18 mg). The onset and duration of sensory block at dermatome level T10, maximum upper and lower spread of sensory block, intensity, and duration of motor block were recorded.

STATISTICAL ANALYSIS

Block characteristics were compared using the two-tailed Mann - Whitney U-test. The proportion of side effects was compared using the Chi-square test.

RESULTS

The median time of onset of sensory block at the T10 dermatome was 4.4±1.3 min in group B and 6.0±1.03 min in group A. The median time to maximum block height was 16.7±3.7 min in group A and 12.03±1.96 min in group B. The median duration of complete motor recovery (B0) was significantly shorter in the heavy ropivacaine group (166.5±11.7 min) compared with the isobaric ropivacaine group (192.9±9.6 min).

CONCLUSIONS

Intrathecal hyperbaric ropivacaine provides more rapid, adequate, and good quality of sensory and motor block with rapid post-operative recovery as compare to isobaric ropivacaine.

摘要

背景

与等比重罗哌卡因相比,重比重罗哌卡因产生的感觉和运动阻滞更可靠,起效更快,肌肉松弛质量更好。因此,本研究旨在比较重比重罗哌卡因与等比重罗哌卡因在下腹部手术患者中的疗效。

方法

对两组患者进行随机对照双盲研究。A组(n = 35)接受3 ml 6 mg/ml的等比重罗哌卡因(18 mg)。B组(n = 35)接受3 ml 6 mg/ml的重比重罗哌卡因(18 mg)。记录T10皮节感觉阻滞的起效时间和持续时间、感觉阻滞的最大上下扩散范围、强度以及运动阻滞的持续时间。

统计分析

使用双尾曼-惠特尼U检验比较阻滞特征。使用卡方检验比较副作用的比例。

结果

B组T10皮节感觉阻滞的中位起效时间为4.4±1.3分钟,A组为6.0±1.03分钟。A组达到最大阻滞高度的中位时间为16.7±3.7分钟,B组为12.03±1.96分钟。重比重罗哌卡因组完全运动恢复(B0)的中位持续时间(166.5±11.7分钟)明显短于等比重罗哌卡因组(192.9±9.6分钟)。

结论

与等比重罗哌卡因相比,鞘内注射重比重罗哌卡因可提供更快速、充分且质量良好的感觉和运动阻滞,术后恢复也更快。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5081/3757795/f20a9bf01449/SJA-7-249-g003.jpg

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