Bhat Sonal N, Upadya Madhusudan
Department of Anaesthesiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
Anesth Essays Res. 2013 Sep-Dec;7(3):381-5. doi: 10.4103/0259-1162.123252.
A prospective randomized clinical study was conducted to study the efficacy and safety of ropivacaine with bupivacaine intrathecally for lower abdominal and lower limb surgeries.
70 patients aged between 18 to 65 years were randomized into two groups, n = 35 in each group. Group A received 3 ml of (0.5%) isobaric bupivacaine (15 mg) and Group B 3 ml of (0.75%) isobaric ropivacaine (22.5 mg). Spinal anesthesia procedure was standardized. Haemodynamic parameters, onset and duration of sensory and motor blockade, level achieved, regression and side effects were compared between the two groups.
Onset and regression of sensory blockade in ropivacaine group was faster with a P < 0.001 which was statistically significant. Onset of motor blockade was rapid in both the groups but duration of motor blockade was significantly shorter in ropivacaine group. Excellent analgesia, with no side effects and stable haemodynamics was noted in ropivacaine group.
Hence ropivacaine was safe and equally effective as bupivacaine for lower abdominal and lower limb surgeries with early motor recovery, providing early ambulation.
开展了一项前瞻性随机临床研究,以探讨鞘内注射罗哌卡因与布比卡因用于下腹部及下肢手术的有效性和安全性。
将70例年龄在18至65岁之间的患者随机分为两组,每组n = 35例。A组接受3毫升(0.5%)等比重布比卡因(15毫克),B组接受3毫升(0.75%)等比重罗哌卡因(22.5毫克)。脊髓麻醉操作标准化。比较两组之间的血流动力学参数、感觉和运动阻滞的起效时间及持续时间、阻滞平面、消退情况和副作用。
罗哌卡因组感觉阻滞的起效和消退更快,P < 0.001,具有统计学意义。两组运动阻滞起效均迅速,但罗哌卡因组运动阻滞持续时间明显较短。罗哌卡因组镇痛效果良好,无副作用,血流动力学稳定。
因此,对于下腹部及下肢手术,罗哌卡因安全且与布比卡因同样有效,可使运动功能早期恢复,利于早期下床活动。