盐酸氯普鲁卡骶管麻醉的临床观察.doc

氯普鲁卡因与利多卡因小儿骶管麻醉的比较 朱旭 苏保义 黄海娟 张武华 苏向上 【摘要】 目的 研究氯普鲁卡因用于小儿骶管麻醉的可行性与安全性。方法：62例在骶管麻醉下行下肢或会阴部手术患儿（3-8岁），随机、双盲分为氯普鲁卡因组（实验组）和利多卡因组（对照组），每组31例。清醒或吸入七氟烷诱导后行骶管穿刺（垂直穿刺法），分别一次性注入1.5%氯普鲁卡因或0.8%利多卡因1mlkg-1。观察记录心率、血压、呼吸频率和血氧饱和度，起效时间、疼痛消失时间、麻醉平面固定时间、麻醉持续时间与最高阻滞的感觉神经节段。结果 实验组（21例完成观察）起效1.52±0.71（min），疼痛消失4.07±0.82（min），麻醉平面固定6.50±0.71（min）。对照组（19例完成观察）起效3.95±0.97（min），疼痛消失5.93±1.57（min），麻醉平面固定时间8.59±1.68（min）（p<0.01）。麻醉持续时间，实验组78.52±5.71（min）；对照组效时间81.38±6.68（min）（p>0.05）。两组最高感觉阻滞神经节段相当。用药后心率、血压、呼吸频率和血氧饱和度变化两组对比无明显差异。两组患儿均无明显不良反应。结论 1.5%氯普鲁卡因骶管阻滞用于3-8岁小儿较0.8%利多卡因起效、疼痛消失及麻醉平面固定快。麻醉持续时间与最高感觉阻滞神经节段相同。呼吸与循环功能基本稳定，无明显不良反应。 关键词 氯普鲁卡因；利多卡因；骶管麻醉；小儿。 Comparision Between Chloroprocaine hydrochloride and Lidocaine hydrochloride In Pediatric Caudal Anesthesia ZhuXu SuBaoYi HuangHaiJuan ZhangWuHua SuXiangShang (Department of Anesthesia,XiaMen [Abstract] Objective To research the feasibility and reliability of chloroprocaine hydrochloride used for pediatric caudal anesthesia. Methods 62 pediatric patients (3—8years old)who had lower extremities or perineum operations were randomly assingned to two groups: chloroprocaine hydrochloride group(the study group) and lidocaine hydrochloride group(the contrast group) with 31cases each.The patients were undergone caudal anesthesia (perpendicular sticking)after received sevoflurane.When the caudal block was succeeded,injection of drug(1.5% chloroprocaine hydrochloride or 0.8%lidocaine hydrochloride) was done accordingly.The indexes of HR、NIBP、RR、SpO2;the onset time 、the time of analgesia 、the time when the level of anesthesia was fixed、the time of maintenance of anesthesia、the highest sense nerve that was blocked were measured and recorded. Results (1)The indexes of the onset time 、the time of analgesia 、the time when the level of anesthesia was fixed in the study group(21 cases had success) have significanly quicker than that of the contrast group (19 cases had success )(p<0.01);(2)The indexes of the time of m