Clinical Observation Of The Domestic Levo-bupivacaine In Subarachnoid Block

This theses explores the clinical effect of applying levo-bupivacaine hydrochloride to subarachnoid block by comparing bupivacaine hydrochloride and observing the clinical potency of applying domestically produced levo-bupivacaine hydrochloride to subarachnoid block.Sixty cases of ASAâ… -â…¡underbelly surgical operations and lower limb surgery patients were selected for this study. In addition, they were stochastically departed into two groups----Group Levo-bupivacaine hydrochloride (Group L, n=30) and Group Bupivacaine hydrochloride (Group B, n=30). To measure BP, HR, SPO2, degree of the move nerve block, block degree ,and the vanishment time of block degree and narcosis, and to observe complications of the surgery after 24h, with the meathod of Epidural-subarachnoid combine lock narcosis and through L2-3 gap puncturing, 0.5% levo-bupivacaine hydrochloride and 0.5% bupivacaine hydrochloride which were diluted by 50% glucose injection were separetly injected into subarachnoid for 1, 3, 5, 10,and 15 min.The study demonstrates that, after being anesthetised for 5min, the blood pressure of Group B drops obviously, Group B's time of blockage degree vanishment and the move nerve changing to block three degree is shorter than Group L's , besides, Group B has a higher incidence of urinates retention than Group L. In addition, other complications were not found in both groups.Comparing to applying bupivacaine hydrochloride to subarachnoid block, the clinical effect of applying levo-bupivacaine hydrochloride to subarachnoid block is better, because of its more stable circulation, shoter vanishment time of degree and narcosis , and less toxicity towards the central nervous system and heart. Therefore, it's safer and more reliable to be used in the narcosis of short surgeries.From my point of view, there is a bright prospect of applying levo-bupivacaine hydrochloride subarachnoid block to abdominal delivery and other surgeries which patients are easily poisoned by bureau anesthetic such as cyesis, oxygen deficiency, acid-intoxication, hyperkalemia, diabetes, and so on, since thelevo-bupivacaine hydrochloride's toxicity towards the central nervous system and heart is obviously less than the bupivacaine hydrochloride's. Although it's safe and valid to apply levo-bupivacaine hydrochloride to subarachnoid block, the differences of indications, disposing concentration and using dosage exists between levo-bupivacaine hydrochloride and bupivacaine hydrochloride because of their differences in pharmacodynamics and medicine generation of dynamics. Accordingly, how to master this form of narcosis's indications, the using dosage ,ect ,should be explored further in the clinical considerations and experiments in future.