氯普鲁卡因用于产科硬膜外麻醉的临床观察

Clinical Observation of Epidural Anesthesia with Chloroprocaine in Caesarean Section

目的观察氯普鲁卡因硬膜外阻滞用于剖宫产术的麻醉效果及安全性。方法选择100例足月单胎孕妇,随机分为3%氯普鲁卡因(观察组)和2%利多卡因(对照组),每组50例,均采用L1-L2硬膜外麻醉。观察麻醉起效、运动阻滞起效、持续时间、麻醉诱导至胎儿娩出时间(I-D)、子宫切开至胎儿娩出时间(U-D)、VAS评分及新生儿NACS、Apgar评分、血气分析。结果观察组麻醉起效、运动阻滞起效、持续时间、I-D明显快于对照组(P<0.05),观察组术中无痛病例数显著高于对照组(P<0.05),两组新生儿NACS、Apgar评分无明显差异(P>0.05),母婴血气分析两组差异无统计学意义(P>0.05)。结论氯普鲁卡因应用于硬膜外麻醉具有阻滞速度快,镇痛完善,运动恢复快,安全性高,不影响NACS、Apgar评分,适用于产科剖宫产手术麻醉。

Objective To investigate the effect and safety of epidural anesthesia with chloroprocaine in caesarean section. Methods 100 cases of full term pregnancy with single fetus were randornly divided into Group 3 % chloroprocaine （observation group） and Group 2% lidocaine （control group）. Each group contained 50 cases, and epidural anesthesia was performed at L1-L2. The onset and duration of analgesia, the onset and duration time of motor block, time from anesthesia induction to fetal delivery （I-D）, time from hysterotomy to fetal delivery （U-D）, VAS score, Apgar score and blood gas analysis were observed. Results The onset and duration of anaesthesia and I-D in observation group were obviously shorter than those in control group （ P 〈 0.05）, while no differences were found in NACS and Apgar score of neonatus between two groups.As for the blood gas analysis, there was no obvious difference in both groups （ P 〉 0.05）. Conclusion Epidural anesthesia with chloroprocaine Ires fast blockage effect, complete analgesia, short motor block and a good safety, and it Ires no effect on NACS and Apgar score. Chloroprocaine can be widely used in caesarean section.