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目的 观察比较罗哌卡因硬膜外 ,硬—脊联合阻滞用于经尿道输尿管肾镜气压弹道碎石术的麻醉效果。方法 ASAⅠ～Ⅱ级行择期经尿道输尿管肾镜气压弹道碎石术病人 45例随机分成 3组 ,Ⅰ组罗哌卡因 0 .75 %T1 0～ 1 1间隙硬膜外阻滞 ,Ⅱ组行L2～ 3间隙硬膜外阻滞 ,Ⅲ组行 0 .3 3 %罗哌卡因硬—脊联合阻滞。观察比较感觉阻滞起效时间、感觉恢复时间、麻醉平面、镇痛效果。结果 Ⅲ组感觉阻滞起效明显快于Ⅰ、Ⅱ组 (P <0 .0 1) ,其感觉阻滞持续时间长于Ⅰ、Ⅱ组 ,并且其对血压影响大于其它两组 (P <0 .0 5 ) ;3组术中镇痛效果依次为第Ⅲ、Ⅰ、Ⅱ组 (P <0 .0 5 )。Ⅰ、Ⅱ组感觉阻滞起效及阻滞时间相仿 (P >0 .0 5 )。结论 :罗哌卡因硬膜外阻滞和硬—脊联合阻滞均可用于经尿道输尿管肾镜气压弹道碎石术麻醉 ,以硬—脊联合阻滞效果为佳
Objective To compare the anesthetic effects of epidural rhadocaine epidural and hard-ridge blockade in transurethral ureteroscopic pneumatic lithotripsy. Methods Forty-five patients with stage ASA Ⅰ ~ Ⅱ elective transurethral ureteroscopic pneumatic lithotripsy were randomly divided into 3 groups. Group Ⅰ received 0.75% T1 0 ~ 1 1 gap epidural blockade of group R, L2 ~ 3 gap epidural block, group Ⅲ line 0.33% ropivacaine hard-ridge block. Observe the feeling of block onset time, feeling recovery time, anesthesia plane, analgesic effect. Results The onset of sensory block in group Ⅲ was significantly faster than that in group Ⅰ and Ⅱ (P <0.01). The sensory block was longer in group Ⅲ than in groups Ⅰ and Ⅱ, and its influence on blood pressure was greater than that in other two groups (P <0. 0 5). The analgesic effects of the three groups were ranked Ⅲ, Ⅰ and Ⅱ (P <0.05). The onset and duration of sensory block in Ⅰ and Ⅱ groups were similar (P> 0.05). Conclusion: Ropivacaine epidural block and hard-ridge blockade can both be used for transurethral ureteroscopic pneumatic lithotripsy to improve the effect of hard-ridge blockade