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0.75%等比重罗哌卡因与0.5%等比重布比卡因在择期腹股沟疝修补手术中鞘内注射的临床疗效前瞻性比较观察研究。

A Prospective Comparative Observational Study of Clinical Efficacy of Isobaric Ropivacaine 0.75% with of Isobaric Bupivacaine 0.5% Intrathecally in Elective Inguinal Hernia Repair Surgeries.

作者信息

Parekh Shivam Bipin, Parikh Suchita Shailesh, Patel Harsha, Mehta Malini

机构信息

Department of Anaesthesia, Government Medical College and Civil Hospital, Surat, Gujarat, India.

Department of Anaesthesia, Padmashree Dr. D. Y. Patil Medical College and Research Center, Navi Mumbai, Maharashtra, India.

出版信息

Anesth Essays Res. 2017 Jul-Sep;11(3):561-566. doi: 10.4103/aer.AER_105_17.

Abstract

AIMS

To evaluate the efficacy of intrathecal isobaric Ropivacaine and its comparison with intrathecal isobaric Bupivacaine in elective inguinal hernia repair surgeries.

SETTINGS AND DESIGN

A prospective, randomized study was conducted in a tertiary care hospital with 80 patients of ASA grade I-III undergoing elective inguinal hernia repair surgery under spinal anaesthesia. Ethical committee clearance and written consent taken. The patients were randomly divided into two equal groups to the Ropivicaine group (Group R) and to theBupivicaine group (Group B). Parameters observed were onset and duration of sensory and motor block, maximum sensory level achieved degree of motor blockade, two segment regression, and haemodynamic changes.

RESULTS

The development of sensory block was faster with Isobaric Ropivicaine (12.1 ± 4.9 minutes) as than isobaric Bupivicaine (13.94 ± 4.52 minutes) but the difference was not statistically significant. Onset of Grade III Motor block was longer with Isobaric Ropivicaine (8.51 ± 3.39 minutes) as compared to isobaric Bupivicaine (8.51 ± 3.39 minutes), but the difference was not statistically significant. Time of Complete Sensory Regression was significantly shorter with Isobaric Ropivicaine (212.69 ± 27.31 minutes) with statistical significance. Time to complete motor recovery was significantly shorter in Ropivacaine group (253.38 ± 27.13 minutes)as compared to Bupivacaine group (258.55 ± 35.81min), with statistical significance. Time to achieve discharge criteria was relatively shorter with Isobaric Ropivicaine. Haemodynamic Parameters did not differ significantly in both the groups during the entire study period.

CONCLUSION

Intrathecal administration of isobaric Ropivacaine (0.75%) 15 mg provides similar quality of spinal anaesthesia but of significantly shorter duration, maintaining similar hemodynamic stability and discharge criteria without significant adverse effects when compared to isobaric Bupivicaine (0.5%) 10 mg.

摘要

目的

评估鞘内注射等比重罗哌卡因的疗效及其在择期腹股沟疝修补手术中与鞘内注射等比重布比卡因的比较。

设置与设计

在一家三级护理医院进行了一项前瞻性随机研究,80例ASA I-III级患者在脊麻下接受择期腹股沟疝修补手术。获得伦理委员会批准并取得书面同意。患者被随机分为两组,罗哌卡因组(R组)和布比卡因组(B组)。观察的参数包括感觉和运动阻滞的起效时间和持续时间、达到的最大感觉平面、运动阻滞程度、两个节段的消退情况以及血流动力学变化。

结果

等比重罗哌卡因(12.1±4.9分钟)感觉阻滞的起效比等比重布比卡因(13.94±4.52分钟)快,但差异无统计学意义。等比重罗哌卡因(8.51±3.39分钟)III级运动阻滞的起效时间比等比重布比卡因(8.51±3.39分钟)长,但差异无统计学意义。等比重罗哌卡因完全感觉消退时间(212.69±27.31分钟)明显较短,具有统计学意义。罗哌卡因组(253.38±27.13分钟)完成运动恢复的时间比布比卡因组(258.55±35.81分钟)明显短,具有统计学意义。等比重罗哌卡因达到出院标准的时间相对较短。在整个研究期间,两组的血流动力学参数无显著差异。

结论

与等比重布比卡因(0.5%)10mg相比,鞘内注射等比重罗哌卡因(0.75%)15mg提供相似质量的脊麻,但持续时间明显较短,维持相似的血流动力学稳定性和出院标准,且无明显不良反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c177/5594767/3781e8c25e67/AER-11-561-g008.jpg

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