不同局麻药物在玻璃体手术中麻醉效果的研究

发布时间：2018-04-01 12:04

本文选题：利多卡因　切入点：布比卡因　出处：《眼科》2017年02期

【摘要】：目的客观分析和判定在玻璃体视网膜手术中布比卡因和罗哌卡因分别与利多卡因混合进行球后麻醉的效果。设计前瞻性比较性病例系列。研究对象93例接受23G玻璃体切除术的患者通过随机数字表法平均分入A、B、C三组,每组31例(31眼)。方法对每组患者球后麻醉注射不同局麻药物,其中A组注射2%利多卡因2.25 ml和0.5%布比卡因2.25 ml混合溶液,B组注射2%利多卡因3 ml和1%罗哌卡因1.5 ml混合溶液,C组注射2%利多卡因溶液4.5 ml,观察术中麻醉效果和术后疼痛情况。主要指标术中感觉阻断时间、运动失能开始时间、术后疼痛开始时间、麻醉效果评价。结果 A、B、C三组的平均感觉阻断时间分别为(2.10±0.10)分钟、(2.13±0.11)分钟、(2.14±0.13)分钟,组间比较无统计学差异(F=0.800,P=0.456)。三组的平均运动失能开始时间分别为(3.10±1.16)分钟、(3.63±1.11)分钟、(3.24±1.63)分钟,组间比较无统计学差异(F=2.000,P=0.138)。三组的术后疼痛开始时间分别为(140.57±22.23)分钟、(134.44±26.34)分钟、(87.34±26.53)分钟,组间比较有统计学差异(F=3.500,P=0.035),其中A组和B组较C组明显延长(t=8.5626,7.0146,P均=0.0001)。A、B、C三组中麻醉效果评级达到5级的患者人数分别为18例、14例和9例(A组与B组比较:χ~2=1.0300,P=0.3090;A组与C组比较:χ~2=5.3100,P=0.0210;B组与C组比较:χ~2=1.7300,P=0.1890)。结论罗哌卡因联合利多卡因进行玻璃体视网膜手术的麻醉,具有和布比卡因联合利多卡因基本同等的麻醉效果和持续时间,优于单独使用利多卡因进行麻醉。
[Abstract]:Objective to objectively analyze and determine the effect of bupivacaine and ropivacaine mixed with lidocaine in vitreoretinal surgery for retrobulbar anesthesia. The patients who underwent vitrectomy were divided into three groups: group A, B, B, C by random digital table method. Methods Retrobulbar anaesthesia was administered to 31 eyes of 31 patients in each group. Group A was injected with 2% lidocaine 2.25 ml and 0.5% bupivacaine 2.25 ml mixed solution. Group B was injected with 2% lidocaine 3 ml and 1% ropivacaine 1.5 ml mixed solution. Group C was injected with 2% lidocaine (4.5 ml). Postoperative pain. Main outcome measures: duration of sensory blockade during operation, Results the mean sensory blockade time of the three groups was 2.10 卤0.10 minutes, 2.13 卤0.11 minutes and 2.14 卤0.13 minutes respectively. There was no statistical difference between the three groups. The average onset time of motor disability in the three groups was 3.10 卤1.16 minutes and 3.63 卤1.11 minutes respectively, and there was no statistical difference between the three groups. The onset time of postoperative pain in the three groups was 140.57 卤22.23 minutes and 87.34 卤26.53 minutes, respectively. There was statistical difference between the three groups. The number of patients with grade 5 anesthesia in group A and group B were significantly longer than those in group C: 18 patients with grade 5 and 9 patients in group A and group B were compared with group C: 蠂 ~ 2 ~ 2 ~ (1.0300) P ~ (+) 0.3090 ~ (-1): compared with group C, the number of patients with anaesthesia grade of grade 5 in group A and group B was significantly longer than that in group C and group A (P < 0.05), respectively. The difference between group A and group B was compared with that in group B (P < 0.05), and that between group A and group C was significantly longer than that in group A and group B (P < 0.05). : comparison between group B and group C: 蠂 ~ 2 ~ (2 +) ~ (5.3100) P ~ (0.0210): 蠂 ~ (2 +) 21.7300 (P ~ (0.1890)). Conclusion ropivacaine combined with lidocaine is anaesthetized for vitreoretinal surgery. It has the same anesthetic effect and duration as bupivacaine combined with lidocaine, and is superior to lidocaine alone.
【作者单位】：武汉大学人民医院眼科中心;
【分类号】：R779.6

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