等比重布比卡因腰硬联合麻醉在剖宫产术中的应用

Equal specific weight of Bupivacaine for combined spinal-epidural anesthesia in cesarean section

目的观察等比重布比卡因行腰-硬联合麻醉(combined spinal-epidural anesthesia,CSEA)用于剖宫产术的临床效果。方法60例拟行剖宫产的足月单胎产妇均在腰-硬联合麻醉下行剖宫产术,随机分为重比重腰-硬联合麻醉组(H组)和等比重腰-硬联合麻醉组(M组)各30例,观察两组麻醉起效时间、麻醉平面、麻醉效果、麻醉并发症、新生儿Apgar评分。结果两组麻醉显效时间、麻醉效果、新生儿Apgar评分无显著差异。H组麻醉平面出现时间明显快于M组,对运动神经阻滞程度和对呼吸循环功能抑制程度H组明显大于M组。结论等比重布比卡因腰-硬联合麻醉虽然出现平面时间稍晚,阻滞平面扩散略窄,但麻醉作用仍然可靠,对产妇及胎儿影响均小,更适合于临床麻醉。

Objective：To observe the efeets of equal specific weight of Bupivacaine for combined spinal-epidural anesthesia in cesarean section.Methods：60 healthy parturients of full-term singleton pregnancies matemal were randomly divided into the heavy proportion of spinal - epidural anesthesia group （H group） and isobaric spinal - epidural anesthesia group （M group） each 30 cases. After subarachnoid injection,we observed the time of onset and motor block,the peak sensory blocked level,anesthetic effect, anesthesia complications, neonatal Apgar score. Result： Two groups of anesthesia onset time, anesthetic effect, neonatal Apgar score was no significant difference. H group of the time of anesthesia occurred significantly faster than the M group, On the degree of motor block and inhibition of respiratory and circulatory function of H group was significantly greater than the M group. Condusion： Isobaric bupivaealne spinal - epidural anesthesia even in the face plane at a later stage, block the proliferation of slightly narrower plane, but the anesthetic effect is still reliable, on maternal and fetal effects are smaller, more suitable for clinical anesthesia.