氯普鲁卡因与利多R因用丁•低位硬膜外麻醉的多中心临床研究代海滨于金贵于布为段满林赵新民金毅类维富徐建国【摘要】目的：比较研究氯普鲁卡因与利多卡因用于低位硬膜外麻醉的临床效应。方法:南京军区南京总医院等三所医院参加该项多小心临床研究。采用随机双盲的方法分组进行研究，择期下腹部或下肢手术病人120例，分为试验组3%氯普鲁卡因组和对照组2%利多卡因组各60例。硬膜外注入试验剂量亦1后5min,一次性注入追加剂量10ml,观察麻醉起效时间，痛觉消失时间，最高阻滞平面及时间，痛觉恢复时间，运动恢复时间，肌肉松弛程度以及呼吸、循环系统的变化。结果：两组麻醉起效时间、痛觉消失时间、痛觉恢复时间、最高阻滞平面、肌松程度比较，都无统计学差界(P>0.05),而试验组的最高阻滞平面吋间(12.1±4.0min)>运动恢复至改良Bromage评分1分的时间(56.8±10.9min)>改良Bromage评分0分的时间(67.6±16.9min)都较对照组(15.4±5.4min>69.1±14.1min、80.4+20.7min)明显缩短(P<0.05)o在破膜外麻醉后5min,试验组的DBP校对照组显著降低(P<0.05),其余各时间点的生命体征(SBP、DBP、HR、SpO2)两组比较均无统计学弟异(P>0.05)。与麻醉前相比，试验组的SBP在麻醉后lOmin至30min都下降(PV0.05)；而对照组的SBP仅在麻醉后lOmin至20min下降(PV0.05)。试验组的DBP在麻醉后5min至30min,都较麻醉前下降(P<0.05)；Iflj对照组的DBP仅在麻醉后15min>20min下降(P<0.05)。结论：氯普鲁卡因用于硬膜外麻醉起效迅速、感觉和运动阻滞效果好，R运动功能恢复快，尤适合于临床屮、短手术。【关键词】硕膜外麻醉，氯普鲁卡因，利多卡因，【中图号】【文献标识码】Lowepiduralanesthesiawithchloroprocaineorlidocaine:aprospective,randomized,double-blindmulticentreclinicaltrialinChinaDAIHaibin,YU激ngui,YUBuwei,DUANManlin,ZHAOXinmin,激NYi,LEIWeifu,XU激anguo[Abstracts]Objective:Tocomparetheclinicalefficacyoflowepiduralanesthesiawithchloroprocaineorlidocaine.METHOD:OnehundredandtwentypatientsundergoinglowerlimborlowerabdominalsurgeryfromthreehospitalsinChinawererandomlyallocatedtoreceive3%chloroprocaine(sixtycases)or2%lidocaine(sixtycases).Fiveminutesafteratestdoseof5mlanesthetic,abolusof10mlanestheticfollowedintoepiduralspace.Ablindedobserverrecordedtheonsettimeofepiduralblock,painfree,theupperblocklevel,painrecovery,andmotorrecovery.Theupperblocklevel,thedegreeofmusclerelaxation,andthevitalsignswerealsorecorded.RESULTS:Therewasnosignificantdifferenceinregardwiththeonsettimeofepiduralblock,painfree,andpainrecovery,theupperblocklevel,andthedegreeofmusclerelaxationinbothgroups(P>0.05).Theonsettimeoftheupperblocklevel(12.1+4.0min),motorrecoverytomodifiedBromagescore1(56.8+10.9min),andthattomodifiedBromagescore0(67.6±16.9min)inchloroprocainegroupw---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---eresignificantlyshorterthanthose(15.4±5.4min,69.1±14.1min,80.4±20.7min)inlidocainegroup(P<0.05).Diastolicbloodpressureinchloroprocainegroupwassignificantlylowerat5minafterepiduralanesthesiathanthatinlidocainegroup(Pv0・05),andtherewasnosignificantdifferenceatothertimeinvitalsignsinbothgroups(P>0.05).Systolicbloodpressurewassignificantlylowerat10minto30minafterepiduralanesthesiacomparingtothebaselineinchloroprocainegroup(Pv0・05),whileloweronlyat10minto20minafterepiduralanesthesiainlidocainegroup(Pv0・05)・Diastolicbloodpressurewassignificantlylowerat5minto30minafterepiduralanesthesiacomparingtothebaselineinchloroprocainegroup(P<0.05),whileloweronlyat15minand20minafterepiduralanesthesiainlidocainegroup(P<0.05).CONCLUSION:Chioroprocainehasarapidonsettime,canprovidereliablesensoryandmotorblockinepiduralanesthes...