本文選題：利多卡因　切入點(diǎn)：布比卡因　出處：《眼科》2017年02期

【摘要】：目的客觀分析和判定在玻璃體視網(wǎng)膜手術(shù)中布比卡因和羅哌卡因分別與利多卡因混合進(jìn)行球后麻醉的效果。設(shè)計(jì)前瞻性比較性病例系列。研究對(duì)象93例接受23G玻璃體切除術(shù)的患者通過(guò)隨機(jī)數(shù)字表法平均分入A、B、C三組,每組31例(31眼)。方法對(duì)每組患者球后麻醉注射不同局麻藥物,其中A組注射2%利多卡因2.25 ml和0.5%布比卡因2.25 ml混合溶液,B組注射2%利多卡因3 ml和1%羅哌卡因1.5 ml混合溶液,C組注射2%利多卡因溶液4.5 ml,觀察術(shù)中麻醉效果和術(shù)后疼痛情況。主要指標(biāo)術(shù)中感覺(jué)阻斷時(shí)間、運(yùn)動(dòng)失能開(kāi)始時(shí)間、術(shù)后疼痛開(kāi)始時(shí)間、麻醉效果評(píng)價(jià)。結(jié)果 A、B、C三組的平均感覺(jué)阻斷時(shí)間分別為(2.10±0.10)分鐘、(2.13±0.11)分鐘、(2.14±0.13)分鐘,組間比較無(wú)統(tǒng)計(jì)學(xué)差異(F=0.800,P=0.456)。三組的平均運(yùn)動(dòng)失能開(kāi)始時(shí)間分別為(3.10±1.16)分鐘、(3.63±1.11)分鐘、(3.24±1.63)分鐘,組間比較無(wú)統(tǒng)計(jì)學(xué)差異(F=2.000,P=0.138)。三組的術(shù)后疼痛開(kāi)始時(shí)間分別為(140.57±22.23)分鐘、(134.44±26.34)分鐘、(87.34±26.53)分鐘,組間比較有統(tǒng)計(jì)學(xué)差異(F=3.500,P=0.035),其中A組和B組較C組明顯延長(zhǎng)(t=8.5626,7.0146,P均=0.0001)。A、B、C三組中麻醉效果評(píng)級(jí)達(dá)到5級(jí)的患者人數(shù)分別為18例、14例和9例(A組與B組比較:χ~2=1.0300,P=0.3090;A組與C組比較:χ~2=5.3100,P=0.0210;B組與C組比較:χ~2=1.7300,P=0.1890)。結(jié)論羅哌卡因聯(lián)合利多卡因進(jìn)行玻璃體視網(wǎng)膜手術(shù)的麻醉,具有和布比卡因聯(lián)合利多卡因基本同等的麻醉效果和持續(xù)時(shí)間,優(yōu)于單獨(dú)使用利多卡因進(jìn)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 鹵0.10 minutes, 2.13 鹵0.11 minutes and 2.14 鹵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 鹵1.16 minutes and 3.63 鹵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 鹵22.23 minutes and 87.34 鹵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.
【作者單位】： 武漢大學(xué)人民醫(yī)院眼科中心;
【分類(lèi)號(hào)】：R779.6

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