Clinical observation of ropivacaine mesylate in combined spinal epiduaral anesthesia of hypogastric operations of elder patient / 中国基层医药

ABSTRACT

Objective To investigate the effect and safety of Ropivacaine mesylate in combined spinal-epid uaral anesthesia of hypogastric operations of elder patient.Methods 90 cases patients scheduled for the lower abdominal surgery were randomly divided into two groups(appendectomy and Oblique inguinal hernia neoplasty).group Ropivacaine mesylate(group A,n=45),group upivacaine hydrochloride(group B,n=45),A,B groups,punctures were selected between L2～L3 ,Hyperbaric solution of Ropivacaine mesylate were injected intrathecaly respectively in two groups,(compoundinggroup A0.894% Ropivacaine hydrochloride 1.5ml+10% Glucose lml)and group B;(0.75% Bupivacaine hydrochloride 1.5ml+10% Glucose lml).The two groups after the subarachnoid medication Indwelling catheter to the cephalic in the epidural space.The time of anaesthetic emergence,maintainance,and the anaesthetic level were observed;the analgetic effect was assessed;movement signs of the lower limbs were observed;blood pressure,respiration and SpO2 .postoperative complications were observed.Results There was apparent differentiation between group A which Systob'c blood pressure declined 8.9% ,heart rate decreased 6.7% ,intraoperative nausea came up to 6.7% after anaesthesia and group B which was 28.9% ,20% ,17.8% ,respectively(P ＜ 0.05).The effective time of anaesthetic emergence was(52.0 ±21.5)s and(13.2 ±3.3)min in group A longer than group B was(41.2±18.2)s and(11.3 ±3.6)min(P＜0.01).There was no difference in Sp02,Bromage Score about extreme movement blockage degree(2.3 ±0.7;2.2 ±0.5),the incidence of postoprative headache(0% ;2.2%)between the group A and group B(P ＞ 0.05).Conclusion Ropivacaine mesylate can be used effectively and safetly in combined spinal-epiduaral anesthesia applied in hypogastric operations of elder patients,for cardiovascular stability is superior to bupivacaine.