老年患者罗哌卡因与布比卡因蛛网膜下腔阻滞效果的比较

比较老年患者下肢手术罗哌卡因与布比卡因蛛网膜下腔阻滞效果．方法：择期骨科下肢手术的高龄病人80例，随机分为两组，R组（n=40）蛛网膜下腔注入5mg／ml罗哌卡因3ml，B组（n=40）蛛网膜下腔注入5mg／ml布比卡因3m1．采用针刺法评估感觉阻滞效果，记录感觉阻滞起效时间、运动阻滞起效时间、最高感觉阻滞平面、麻醉维持时间、术中麻醉质量与肌松效果及用药后的不良反应．结果：与B组比较，R组运动阻滞起效时间较长，运动阻滞和感觉阻滞维持时间较短（P〈0．05）；感觉阻滞起效时间差异无统计学意义（P〉O．05）；两组麻醉质量和肌松效果均较好，麻醉质量及肌松效果无统计学差异（P〉0．05）；两组不良反应发生率均较低，且差异无统计学意义（P〉0．05）．结论：老年病人下肢手术患者采用罗哌卡因蛛网膜下腔阻滞术中麻醉质量及肌松效果良好，且其运动阻滞维持时间较布比卡因短，有利于术后的恢复和功能锻炼．表4，参7．

Comparison of the Efficiency of Ropivacaine and Bupivacaine for Spinal Anesthesia in Elderly Patients Undergoing Lower Limb Surgery

Objective ： To compare the efficiency of ropivacaine and bupivacaine for spinal anesthesia in elderly patients undergoing lower limb surgery. Methods： Eighty patients were randomly divided into two groups. Group R （ n = 40） received intrathecally 3 ml of ropivacaine 5 mg/ml and Group B （ n = 40） received intrath- eeally 3 ml of bupivacaine 5 mg/ml. The degree of sensory block, the onset time and duration were recorded. The quality of anesthesia and degree of muscle relaxation during operation were assessed and the adverse effects were also recorded. Results：The onset time of motor block was significantly longer and the duration of motor and sensory block was significantly shorter in Group R than that of Group B （ P 〈 0.05 ）. There was no significant difference in the onset time of sensory block （ P 〉 0.05 ）. The quality of anesthesia and degree of muscle relaxation were good in both groups and there was no significant difference （ P 〉 0.05 ）. Conclusion ： The quality of anesthesia and degree of muscle relaxation were good during operation in patients undergoing lower limb surgery when the spinal anesthesia was performed with ropivacaine. The duration of motor block of ropivacaine is shorter than that of bupivacaine. 4tabs. ,7refs.