摘要
目的 探讨国产氯普鲁卡因脊麻的可行性和安全性。方法 40例产妇经L2~3行脊麻-硬膜外联合穿刺,向蛛网膜下隙注入氯普鲁卡因脊麻合剂(2.5%氯普鲁卡因1.2ml+10%葡萄糖0.5m1+3%麻黄碱0.5ml)2.2ml/30-40s。结果 (1)麻醉起效时间、T11无痛时间、双下肢不能抬起时间、达到最高阻滞平面的时间分别为(22.78±9.52)s、(3.65±0.86)、(3.67±0.73)和(8.04±1.11)min;最高阻滞平面为T4.05±1.38;麻醉消退T11开始疼痛时间、双下肢能抬起时间、麻醉完全消失时间分别为(54.75±8.60)、(68.63±13.22)和(77.50±16.97)min。(2)术中产妇无诉痛,腹肌松弛。(3)麻醉后出现低血压反应17例(42.5%),出现时间(5.21±1.67)min,给予麻黄碱15mg后均好转。心率相对稳定。SpO2正常。(4)麻醉后恶心22例(55%),其中12例(30%)发生在切开子宫前,与低血压有关,其他与手术操作有关;呕吐16例(40%),娩胎前5例,娩胎后11例。(5)麻醉后及其术后1个月内未见任何精神神经系统不良反应。(6)氯普鲁卡因脊麻合剂pH值和比重分别为6.12±0.46,1.012±0.003。结论 产氯普鲁卡因可安全有效地用于脊麻。
Objective To study the possibility and safety of domestic chloroprocaine used for spinal anesthesia. Methods Fourty primiparas were punctured at lumbar 2-3 spinal interspace and injected a 2.2 ml mixture (2.5% chloroprocaine 1.2 ml, 10% glucose 0.5 ml, 30% ephedrine 0. 5 ml) within 30-40 seconds into subarachnoid space. Results (1) The onset time, thoracic 11 pain-free time,the time when lower limbs were unable to lift up,and the time of reaching to the highest nerve block level were (22.78±9.52) s,(3.65±0.86), (3.67±0.73) and (8.04±1.11) min, respectively. The highest nerve block mean level were thoracic 4. 05 ± 1.38. The time of nerve block fade to thoracic 11, time of lower limbs being able to lift up and time of anesthesia complete disappearance were (54.75±8.60) ,(68.63±13.22) and (77.50±16.97) min, respectively. (2) None of primiparas complained surgical pain, and primiparas' abdominal muscles were highly relaxed. (3) Hypotensions occurred at mean time(5.21 ± 1.67) min in 17 cases (17 %) after anesthesia, and were effectively corrected by ephedrine. (4) Nausea and vomiting were 22 (55%) cases, of which 12 (30%) were associated with hypotension, and 16 (40 %), respectively, during anesthesia and operation. (5) We could not any observe systemic and spinal nerve toxic responses. (6) pH and specific gravity of the mixture were 6.12±0.46 and 1. 012±0. 003, respectively. Conclusion 2.50% chloroprocaine can be used safely and effectively for spinal anesthesia.
出处
《临床麻醉学杂志》
CAS
CSCD
2006年第6期424-426,共3页
Journal of Clinical Anesthesiology
关键词
氯普鲁卡因
脊麻
Chloroprocaine
Spinal anesthesia