左旋布比卡因腰麻用于剖宫产手术的临床观察

Clinical observations of levobupivocaine subarachnoid block in caesarean operation

目的:比较左旋布比卡因与布比卡因和罗哌卡因腰麻用于剖宫产手术的麻醉效应。方法:选择ASAI～Ⅱ级,拟在腰麻下行剖宫产手术病人90例,随机分为3组,即布比卡因组(B组,n=30)、罗哌卡因组(R组,n=30)和左旋布比卡因组(LB组,n=30)。所有病人腰麻均接受0.5%重比重相应局麻药2.4mL(12mg)。记录各组感觉和运动神经阻滞的起效时间和维持时间、药物不良反应。肌松程度由手术医生评定,镇痛情况由病人自我评定。结果:3组病人的感觉阻滞起效时间、维持时间、最高阻滞平面差异无显著性(P>0.05);LB组的运动阻滞起效时间比R组快、比B组慢,而运动阻滞维持时间比R组长、比B组短(P<0.05);最大Bromage评分B组>LB组>R组(P<0.05);主要的药物不良反应为低血压、恶心、呕吐等。结论:左旋布比卡因腰麻用于剖宫产手术是安全的,并能达到较为完善的麻醉效果。

Objective To compare the anesthetic effects of levobupivacaine, bupivaeaine and ropivacaine in caesarean operation. Methods Ninty patients in ASA Ⅰ - Ⅱ will be performed for caesarean operation under subarachnoid block, were randomly divided into three groups, including bupivaeaine group（B group, n = 30）, ropivacaine（R group, n = 30） and levobupivaeaine（LB group, n =30） . The dosage of subarachnoid block of all patients was 2, 4 mL（12 mg） of corresponding local anthestic of heavy specific gravity. The reacting time, maintaining time of sensory nerve, motonerve block and the side effects of each group were recorded. The muscular relaxant will be evaluated by the surgeons and the analgesia effect by the patient himself, Results There were no significant differences between three groups in reacting time, maintaining time and the highest block level of sensory block after subarachnoid block（ P 〉 0.05） . The reacting time of motonerve block in LB group was faster than that in R group, and lower than that in B group（ P 〈 0.05） . While the maintaining time was longer than that in R group, but shorter than that in B group（ P 〈 0. 05）. The maximal Bromage Score in LB group was bigger than that in R group and less than that in B group （ P 〈 0. 05） . The side effects of three local anesthetics mainly included hypotension, nausea, sicking up and so on, Conclusion LB subarachnoid block in caesarean operation is safe, which can acquire more perfectly anesthetic effect.