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三种不同浓度(0.2%、0.5%和0.75%)的硬膜外罗哌卡因用于下肢骨科手术后镇痛的比较

Comparison of Three Different Concentrations 0.2%, 0.5%, and 0.75% Epidural Ropivacaine for Postoperative Analgesia in Lower Limb Orthopedic Surgery.

作者信息

Pathak Amitesh, Yadav Neeraj, Mohanty Sati Nath, Ratnani Ekta, Sanjeev Om Prakash

机构信息

Department of Anaesthesiology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Department of Anaesthesiology, Max Hospital, New Delhi, India.

出版信息

Anesth Essays Res. 2017 Oct-Dec;11(4):1022-1025. doi: 10.4103/aer.AER_88_17.

Abstract

INTRODUCTION

Ropivacaine has been studied previously and holds promise as an agent that offers a safe, efficacious, and better recovery profile than other conventional agents such as bupivacaine. The aim of the present study was to compare the safety and efficacy of equal volume of different concentration of ropivacaine for epidural analgesia in patients undergoing major lower limb orthopedic surgery.

SUBJECTS AND METHODS

One hundred and fifty adult patients were randomized into three groups to receive single dose of equal volume of ropivacaine through epidural route in concentrations of 0.2%, 0.5%, and 0.75%, respectively. All the groups received equal dose of ropivacaine of same concentration for subarachnoid block using combined spinal-epidural technique.

RESULTS

Modified Bromage Scale and Numeric rating scale was used to assess motor block and analgesia. Data analysis was done using WINDOW SPSS Student Version 17 ANOVA test. Student's -test was performed for comparison between two groups, and qualitative data were analyzed by applying Chi-square test.

CONCLUSION

0.5% and 0.75% ropivacaine were sufficient and effective for intrathecal subarachnoid block as well as for postoperative analgesia with epidural use. Shorter duration of motor blockade and analgesia was seen with ropivacaine 0.2%.

摘要

引言

罗哌卡因此前已被研究,有望成为一种比布比卡因等其他传统药物更安全、有效且恢复情况更好的药物。本研究的目的是比较等体积不同浓度的罗哌卡因用于下肢骨科大手术患者硬膜外镇痛的安全性和有效性。

受试者与方法

150例成年患者随机分为三组,分别通过硬膜外途径接受单剂量等体积浓度为0.2%、0.5%和0.75%的罗哌卡因。所有组使用联合腰麻-硬膜外技术接受相同浓度等剂量的罗哌卡因用于蛛网膜下腔阻滞。

结果

采用改良Bromage量表和数字评分量表评估运动阻滞和镇痛情况。数据分析使用WINDOW SPSS学生版17进行方差分析。两组之间的比较采用Student检验,定性数据采用卡方检验进行分析。

结论

0.5%和0.75%的罗哌卡因用于鞘内蛛网膜下腔阻滞以及硬膜外术后镇痛是足够且有效的。0.2%的罗哌卡因运动阻滞和镇痛持续时间较短。

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