摘要
目的:探讨剖宫产手术中腰麻液布比卡因的最适剂量。方法:360例剖宫产患者随机分为4组,每组90例,腰麻布比卡因剂量A组4mg,B组6mg,C组8mg,D组10mg。记录术前及注药后5min、10min、15min、30min的血压(BP)、心率(HR)以及腰麻平面固定后的绝对平面和相对平面,绝对平面低于1、8者通过硬膜外导管推入1.6%利多卡因并记录推入的数量(ml),BP〈基础值30%或收缩压(SBP)〈90mmHg时静注麻黄素5~10mg,并记录麻黄素的用量(mg)。结果:A组麻醉平面较低,需加入较大量的利多卡因才能满足手术的需要,与其它三组相比差异有显著性(P〈0.05),D组麻醉平面过高,BP,HR变化剧烈,需加用较多的麻黄素以维持BP、HR的稳定,与其它三组相比差异有显著性(P〈0.05),B、C两组麻醉平面适宜,BP、HR稳定,硬膜外加入少量的利多卡因,能取得满意的麻醉效果。结论:剖宫产手术时腰麻布比卡因剂量6~8mg能维持血流动力学稳定,又能很好的满足手术要求。
Objective:To compare the effects and safes of different doses of spinal hyperbaric bupivacaine during combined spinal - epidural anesthesia for elective cesarean section. Methods :360 term parturients undergoing cesarean scction were randomly divided into 4 groups (n = 90 each) and received spinal hyperbaric bupivacaine 4mg (group A), 6mg (group B), 8mg (group C) , 10mg (group D), respectively. Intravenous ephedrine would be given to treat hypotension. If the blocked scusory level were below Ts in 10 minutes, 1.6% epidural lidocaine would be injected. BP, HR, SPO2 were monitored every, 5 minutes, blocked sensory level, the volume of epidural lidocaine supplementation, the dose of ephedrine required, and tbe satisfaction of surgeon were recorded. Results : The blocked sensory level of group A was lower and required significantly more epidural lidocaine ( P 〈 0.05 ). The blocked sensory level in group D was too high to make BP, HR change severely, and requited significantly more dose of intravenous ephedrine ( P 〈 0.05 ). The blocks in group C and group D were reliable, BP, HR were stable, little epidural lidocaine were required, and the surgeons were satisfied. Conclusion :6 -8mg spinal hyperbaric bupivacaine can provide a more reliable and safer block in combined spinal -epidural anesthesia for the term parturients undergoing elective cesarean section.
出处
《赣南医学院学报》
2007年第6期848-849,共2页
JOURNAL OF GANNAN MEDICAL UNIVERSITY
关键词
腰硬联合麻醉
腰麻
布比卡因
剂量
剖宫产
combinedspinal - cpidural anesthesia, hnpivacainc, dose, cesarean scction