比较左旋布比卡因与布比卡因用于腰-硬联合麻醉在剖宫产术中的效果

Comparison of Effect of Levobupivacaine and Bupivacaine for Combined Spinal-epidural Anesthesia in Cesarean Section

目的比较左旋布比卡因与布比卡因用于剖宫产术的麻醉效果。方法将单胎孕妇120例,随机分为左旋布比卡因组(LB组)和布比卡因组(B组)各60例。LB组和B组分别在蛛网膜下腔内注入0.5%左旋布比卡因和0.5%布比卡因各1.8ml。记录两组感觉阻滞、运动阻滞起效时间、运动阻滞程度及恢复时间、腹肌松弛程度、术中产妇血压和心率生命体征的变化情况,以及新生儿Apgar评分。结果两组产妇感觉阻滞、运动阻滞起效时间以及感觉阻滞恢复时间比较差异无统计学意义(P>0.05);两组新生儿不同时点Apgar评分比较差异无统计学意义(P>0.05)。LB组运动阻滞恢复时间明显缩短,术中低血压发生情况更少(P<0.05)。结论与0.5%布比卡因比较,0.5%左旋布比卡因更适用于剖宫产术的腰-硬联合麻醉。

Objective To compare the efficacy of levobupivacaine （LB） and bupivacaine （B） for combined spinal-epidural anesthesia in cesarean section.Methods A total of 120 pregnant women with single fetus underwent cesarean section were randomly divided into group LB and group B （each n=60）.The women in group LB were injected 0.5% lebupivacaine into the subarachnoid space,while the women in group B were injected 0.5% bupivacaine into the subarachnoid space.The onset time of sensory nerve and motor nerve block,the degree of motor nerve block,the recovery time of motor nerve block,the blood pressure,and the Apgar score of neonate were recorded and compared between the two groups.Results There was no statistically significant difference in the onset time of sensory nerve and motor nerve block,and the recovery time of sensory nerve between the two groups （P〉0.05）.No statistically significant difference was found in Apgar scores of different time points between the two groups （P〉0.05）.The recovery time of motor nerve block was shorten and the occurrence of hypotension during the operation was much less in group LB （P〈0.05）.Conclusions As compared with 0.5% bupivacaine,0.5% levobupivacaine is more suitable for combined spinal-epidural anesthesia in cesarean section.