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1、小劑量羅哌卡因與布比卡因腰麻對(duì)排尿功能影響的臨床觀察王仁儒彭志勇陸立仁彭為平梁秀萍劉芪東(廣東省佛山市南海區(qū)人民醫(yī)院麻醉科廣東佛山528200)【屮圖分類號(hào)】R614【文獻(xiàn)標(biāo)識(shí)碼】A【文章編號(hào)】1672-5085(2012)13-0076-02【摘要】目的比較相同劑量羅哌卡因與布比卡因腰麻對(duì)排尿功能的影響。方法取美國(guó)麻醉師協(xié)會(huì)(ASA)I?II級(jí)擇期肛門會(huì)陰部手術(shù)患者60例，隨機(jī)數(shù)字表法分為2組：R組(0.5%羅哌卡因5mg)和B組(0.5%布比卡因5mg)患者分別于L3-4行腰麻。比較2組患者麻醉效果、阻滯平面、MAP、HR、Sp
2、O2、Bromage評(píng)分、術(shù)后24h排尿功能(無障礙自動(dòng)排尿、輕度障礙自行排尿、尿滿留)。結(jié)果2組患者鎮(zhèn)痛、肌松滿意，阻滯平面多在S1呈鞍狀；MAP、HR、SpO2均無明顯改變，Bromage評(píng)分R組為0?1分，24h排尿功能均無障礙，B組1?3分不等，24h排尿功能輕度障礙25例，無尿潴留；2組以上數(shù)據(jù)比較差異均有顯著統(tǒng)計(jì)學(xué)意義(P<0.05)o結(jié)論0.5%羅哌卡因5mg與0.5%布比卡因5mg分別用于肛門會(huì)陰部短小手術(shù)，鎮(zhèn)痛完全，肌松滿意，麻醉阻滯平面局限，對(duì)MAP、HR、SpO2幾乎無影響。小劑量羅哌卡因?qū)ε拍蚬δ艿挠绊?/p>
3、比布比卡因更小，值得推薦?！娟P(guān)鍵詞】羅哌卡因布比卡因腰麻排鉍ClinicalobservationonurinationfunctionofthepatientstreatedbyruningthesmalldoseofbupivacaineorropivacaineinlumbaranesthesiaWangRenru,PengZhiyong，LuLiren,PengWeiping,LiangYiuping,LiuMaodongDepartmentofAnesthesiolody,NanhaiHospitalaffiliatedt
4、otheSouthMedicalUniversity,Foshan528200[Abstract]Tostudytheanesthesiaeffectsandsafetyofthesmalldoseofbupivacaineandropivacaineinlumbaranesthesiainpatientswiththeanusandperinealsurgery.MethodsSixtypatients(ASAI?II)withtheanusandperinealsurgerywererandomlydividedintotwog
5、roupswith30patientseach.GroupRused0.5%ropivacaine(5mg);GroupBused0.5%bupivacaine(5mg).Theanesthesiaeffectswereevaluatedbygoodanalgesia,Bromagescores,MAP,HR,SpO2andurinationfunctionwasalsorecordedat48hoursafteroperation.ResultsThereweregoodanalgesiaandnosignificantdiffe
6、rencesinthepotencyofanalgesia,theblockintheplaneandMuscleloosesatisfactionbetweenGroupBandGroupR(P>0.05).ThereweresignificantdifferencesinBromagescoresinGroupBandGroupR(P<0.05).ThereweresignificantdifferencesinurinationfunctionbetweenGroupCandGroupR(P<0.05).Vi
7、talsignsweresmoothafteroperation.ConclusionsLumbaranesthesiawiththesmalldoseofbupivacaineandropivacaineisthemostsafeandeffectiveforpatientwithanalandperinealshortsurgery,thesmalldoseofropivacainehaslessinfluenceofurinationfunctionthanbupivacaine,Whichisrecommendable.【K
8、eywords]RopivacaineBupivacaineLumbaranesthesiaUrinate腰麻用于肛腸病手術(shù)，效果確切；但術(shù)后尿潴留是常見的并發(fā)癥，其原因是多方面的。本研究采用相同濃度和劑量的羅哌卡因和布比卡因腰麻，比
