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首页> 外文期刊>Current therapeutic research, clinical and experimental. >Effects of Bupivacaine Versus Levobupivacaine on Pulmonary Function in Patients With Chronic Obstructive Pulmonary Disease Undergoing Urologic Surgery: A Randomized, Double-Blind, Controlled Trial
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Effects of Bupivacaine Versus Levobupivacaine on Pulmonary Function in Patients With Chronic Obstructive Pulmonary Disease Undergoing Urologic Surgery: A Randomized, Double-Blind, Controlled Trial

机译：布比卡因与左旋布比卡因对泌尿外科手术后慢性阻塞性肺疾病患者肺功能的影响：一项随机，双盲，对照试验

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BACKGROUND: There are limited data to determine the impact of subarachnoid blockade with local anesthetics on perioperative pulmonary function. The effects of local anesthetics used in spinal anesthesia are very important in terms of respiratory function in patients with chronic obstructive pulmonary disease (COPD).OBJECTIVE: The aim of this study was to evaluate the effects of bupivacaine versus levobupivacaine on pulmonary function in patients with COPD undergoing urologic surgery.METHODS: Patients were randomized into 2 groups: group B (n = 25) received 3 mL of hyperbaric 0.5% bupivacaine; group L (n = 25) received 3 mL of isobaric 0.5% levobupivacaine. Both agents were administered intrathecally. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV_1), peak expiratory flow rate (PEFR), vital capacity (VC), and FEV_1/FVC ratio were measured using spirom-etry 10 and 30 minutes after spinal anesthesia and 30 minutes after completion of the operation. An arterial blood gas test was performed before and after spinal anesthesia.RESULTS: Fifty male patients aged 40 to 80 years completed the study. There were no differences in the results of preoperative and postoperative FVC, FEV_1; PEFR, VC, FEV/FVC ratio, and arterial blood gas between the bupivacaine (n = 25) and levobupivacaine (n = 25) groups. However, patients who took bupivacaine showed a significant decrease in intraoperative PEFR at 30 minutes compared with baseline, a result not seen in patients who took levobupivacaine (P =0.036 and P = 0.282, respectively).CONCLUSIONS: In 50 patients with moderate COPD undergoing urologic surgery, hyperbaric bupivacaine caused a decrease in intraoperative PEFR compared with baseline because of higher level block; however, the effects of hyperbaric bupivacaine and isobaric levobupivacaine on pulmonary function in these patients showed equally effective potencies for spinal anesthesia.
机译：背景：局麻药蛛网膜下腔阻滞术围手术期肺功能的影响的数据有限。在慢性阻塞性肺疾病（COPD）患者的呼吸功能方面，用于脊柱麻醉的局部麻醉剂的作用非常重要。目的：本研究的目的是评估布比卡因和左旋布比卡因对哮喘患者肺功能的影响。方法：将患者随机分为2组：B组（n = 25）接受3 mL高压0.5％布比卡因治疗。 L组（n = 25）接受3 mL等压的0.5％左旋布比卡因。两种药物都通过鞘内给药。分别在脊髓麻醉和麻醉后10分钟和30分钟内使用吸气法测量强迫肺活量（FVC），1秒强迫呼气量（FEV_1），峰值呼气流速（PEFR），肺活量（VC）和FEV_1 / FVC比值。操作完成后30分钟。结果：在50名40至80岁的男性患者中，完成了脊髓麻醉前后的动脉血气测试。术前和术后FVC_1的结果无差异; PEFR，VC，FEV / FVC比值和布比卡因（n = 25）和左旋布比卡因（n = 25）组之间的动脉血气。然而，服用布比卡因的患者在30分钟时的术中PEFR较基线水平显着降低，而服用左旋布比卡因的患者则未见这一结果（分别为P = 0.036和P = 0.282）。结论：在50例中度COPD患者中泌尿外科手术中，高压布比卡因引起的术中PEFR较基线水平降低，原因是较高的阻滞水平;然而，高压布比卡因和同量异位左旋布比卡因对这些患者的肺功能的影响显示出同样有效的脊髓麻醉效力。

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