氯普鲁卡因及布比卡因在臂丛神经阻滞中药效学比较.docVIP

氯普鲁卡因及布比卡因在臂丛神经阻滞中药效学比较【摘要】目的：比较氯普鲁卡因与布比卡因在臂丛神经阻滞中的药效学特性。方法：45例上肢手术患者，ASAⅠ～Ⅱ级，随机分成三组，一组为0.375%布比卡因，二组为2.5%氯普鲁卡因，三组为2.5%氯普鲁卡因加1∶200 000肾上腺素。肌间沟法行臂丛神经阻滞，观察阻滞起效时间及持续时间、神经阻滞节断数、术中镇痛质量、不良反应以及注药前、注药后5、10、30、60分时心率（HR）和平均动脉压（MAP）。结果：二、三组麻醉起效时间短于一组（P＜0.05）；麻醉持续时间二、三组长于一组但差异无显著性；二、三组组间比较差异有显著性；各组阻滞节断数、术中牵涉痛发生率、HR及MAP差异无显著性；一组寒战发生率高于二、三组（P＜0.05）。结论：氯普鲁卡因可安全用于臂丛神经阻滞；肾上腺素明显延长氯普鲁卡因的麻醉持续时间。 【关键词】氯普鲁卡因；布比卡因；臂丛神经阻滞 文章编号：1009-5519（2008）01-0007-03 中图分类号：R614 文献标识码：A Comparison of the pharmacodynamics of chloroprocaine and bupivacaine in brachial plexus block ZHANG Feng-lin，KUAI Jian-ke，LIU Chun-li (Department of Anesthesiology，Tangdu Hospital，The Fourth Military Medical University，Xi’an 710038，China) 【Abstract】Objective：To observe the pharmacodynamics of chloroprocaine and bupivacaine in brachial plexus block. Methods：Fourty-five ASAⅠ～Ⅱ patients undergoing upper limb surgery underbrachial plexus block were divided randomly into three groups，with 15 cases in each group.Group one received 0.375% bupivacaine；Group two 2.5% chloroprocaine;Group three in which 1：200 000 adrenaline was added to 2.5% chloroprocaine. Anesthesis was performed by interscalene brachial plexus block.The onset and duration of analgesia，the level of block as well as adverse effects were recorded.HR and MAP were measured before anesthesia，5，10，30 and 60 minates after anesthesia.Results：The onset time of block was significantly shorter and shivering was significantly lower in groups two and three as compared with group one.There was significant difference in the duration of anesthesia between group two and group three. There was no significant difference in the duration of anesthesia ，the level of block，the incidences of visceral pain，HR and MAP among three groups.Conclusion：Chloroprocaine can be used in clinical brachial plexus block safely，and adrenaline can prolong its duration of anesthesia. 【Key words】Chloroprocaine；Bupivacaine；Brachial plexus block 氯普鲁卡因属苯甲酸酯类的局部麻醉药，由于在普鲁卡因的对氨基苯甲酸二位上用氯原