摘要
目的 比较等比重与重比重布比卡因腰麻在剖宫产手术中应用的优缺点。方法 选择ASA Ⅰ～Ⅱ级的拟行剖宫产手术病例100例．随机分为等比重组（Ⅰ组，50例）或重比重组（H组，50例），用CSEA（联合腰麻硬膜外麻醉）技术的针内针法经L2-3，实施腰麻，均采用0．5％布比卡因2ml，比较两组患者围术期血流动力学变化及注药后病人的反应、麻醉起效及消退时间、感觉阻滞的峰平面等。结果 两组均取得良好的麻醉效果。注药后5～15min出现明显血压下降而需应用麻黄素处理的H组有12例，Ⅰ组仅2例（P〈0．01）。两组病人麻醉起效时间相近。与Ⅰ组相比，H组病例感觉阻滞达峰平面较Ⅰ组快，且峰平面较Ⅰ组高（阻滞节段数较多），感觉阻滞平面下降2节段的时间较Ⅰ组短，伤口疼痛出现较1组早（P〈0．01），运动殂滞消退较Ⅰ组快（P〈0．05）。结论 在剖宫产手术中，等比重液腰麻较重比重液腰麻具有明显的优越性。
Objective To compare the application of isobaric and hyperbaric solution of bupivacacine for spinal anesthesia in caesarean section and provide reference materials for clinical practice. Methods One hundred ASA physical status Ⅲ full term pregnant woman planed to receive cesarean section under spinal anesthesia （using CSEA technique via spinal needle in epidural needle） were randomized to receive subarachnoid injection of 2.0ml （10mg） isobaric （group Ⅰ, 50 cases） or hyperbaric （group H, 50 cases） bupivacaine and then turned supine. Perioperative hemodynamic parameters and patients＇ anesthesia responses were monitored, including the time of onset and motor block, peak sensory blocked level, the time to regression of 2 dermatornes, the time to the first administration of analgesics, the time to the regression of motor block to modified Bromage scale 2. Results Both isobaric and hyperbaric 0..5 % bupivacaine solutions in a volume of 2.0 ml provided effective sensory and motor block. Time to onset and complete motor block was similar. Compared with group Ⅰ, the time to peak sensory block was shorter, peak sensory block level was higher （maximal dermatomes of blocked sensory nerves were more）, time to regression of sensory and motor block was shorter, the incidence of uncomfortable feeling,, nausea, vomit and hypotension was higher in group H. Conclusion Spinal anesthesia with isobaric solution is superior to that with hyperbaric solution as the hemodynamic parameters are relatively stable, the lower incidence of uncomfortable feelings, the lower incidence of other adverse effects, and its longer duration of anesthesia and analgesia.
出处
《实用预防医学》
CAS
2006年第2期386-387,共2页
Practical Preventive Medicine
关键词
剖宫产
腰麻
等比重
重比重
布比卡因
Caesarean section
Spinal anesthesia
Isobaric
Hyperbaric
