《中国康复理论与实践》

《中国康复理论与实践》 ›› 2010, Vol. 16 ›› Issue (8): 725-727.

• 论文 • 上一篇    下一篇

头皮神经阻滞在脑功能区手术中的镇痛作用

曾横宇1，张曦2，程灏1，韩如泉1   

  1. 1.首都医科大学附属北京天坛医院麻醉疼痛科，北京市 100050；2.空军指挥学院医院，北京市 100089
  • 收稿日期:2010-07-27 修回日期:1900-01-01 出版日期:2010-08-25 发布日期:2010-08-25
  • 通讯作者: 程灏

Comparison of Lidocaine and Ropivacaine for Scalp Blockade during Awake Craniotomy

ZENG Heng-yu, ZHANG Xi, CHENG Hao, et al   

  1. The Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
  • Received:2010-07-27 Revised:1900-01-01 Published:2010-08-25 Online:2010-08-25

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摘要： 目的对比研究神经外科唤醒麻醉中利多卡因和罗哌卡因采用临床常用浓度用于头皮神经阻滞的镇痛效果及其对呼吸和循环指标的影响。方法脑功能区胶质瘤择期拟行唤醒麻醉下开颅手术患者60例，随机分为两组：利多卡因(L)组(n=30)和罗哌卡因(R)组(n=30)，切皮前15 min分别采用1%利多卡因或0.5%罗哌卡因行患侧头皮神经阻滞。记录术中镇痛药用药量及呼吸和循环相关指标。结果关颅期循环指标L组平均动脉压和心率高于R组(P<0.05)；镇痛药用药量L组大于R组(P<0.05)。两组患者呼吸指标相比，R组优于L组(P<0.05)。结论在脑功能区占位手术唤醒麻醉中，采用罗哌卡因头皮神经阻滞可以提供更为有效的镇痛效果，不仅降低镇痛药的用药量，同时减少呼吸抑制等副作用的发生，更适宜用于唤醒麻醉中的头皮神经阻滞。

关键词: 神经阻滞, 唤醒开颅术, 利多卡因, 罗哌卡因

Abstract: ObjectiveTo compare the efficacy and safety of lidocaine and ropivacaine for scalp block in providing adequate analgesia with minimum side effects during awake craniotomy.Methods60 patients, ASA 1～2, were randomized into either lidocaine (L) group (n=30) or ropivacaine (R) group (n=30). 1% lidocaine or 0.5% ropivacaine were taken for scalp nerve block 15 min before incision. Supplemental oxygen was given using nasal prongs that were adapted for the monitoring of end tidal CO2 and respiratory rate. Serial parameters about circulation and respiratory were measured and drug consumption were recorded.ResultsThe hemodynamic parameters of L group were higher than R group in the latter stage(P<0.05). L group was associated with significantly more consumption of sufentanil and more respiratory depression than R group(P<0.05).ConclusionRopivacaine, taking for scalp block undergoing awake craniotomy, is associated with less consumption of analgesic and less respiratory depression than lidocaine.

Key words: nerve block, awake craniotomy, lidocaine, ropivacaine