腰硬联合麻醉用于剖宫产时布比卡因腰麻剂量的探讨

The minimal local anesthetic dose of bupivacaine for caesarean section in combined spinal-epidural anesthesia determined by up-and-down method

目的:探讨腰硬联合麻醉(Combined spinal-epidural anesthesia,CSEA)用于剖宫产时,布比卡因的腰麻剂量。方法:采用序贯法设计,选取34例合乎标准的产妇按设定的剂量梯度及方案给药,并连续监测血压、心率、血氧饱和度及心电图,观察麻醉效果(镇痛、肌松),有无不良反应以及进行新生儿评分。结果:腰硬联合麻醉用于剖宫产时,布比卡因腰麻的最低有效剂量为5.03mg(4.1～5.1mg),ED90及ED95分别为7.15、7.89mg。结论:腰硬联合麻醉时用于剖宫产时,欲使大多数产妇麻醉效果好而且临床应用方便可行的布比卡因的腰麻剂量为7.5mg。

Objective：To investigate the minimal local anesthetic dose（MLAD） of bupivacaine for caesarean section in combined spinal-epidural anesthesia（CSEA）.Methods：Designed by up-and-down,34 parturients who met the standards were given bupivacaine as planned dose gradient.Hemodynamics were monitored continuously,untoward effects were observed and APGAR of the neonates were given.Results：The MLAD of bupivacaine which is used in CSEA for caesarean section is 5.03 mg（4.1～5.1 mg）,and that of ED90 and ED95 are 7.15 mg,7.89 mg respectively.Conclusion：The clinical easy to use dose of bupivacaine is 7.5 mg which is used in CSEA for most parturients.