小剂量布比卡因-芬太尼腰硬联合麻醉在急诊剖宫产术中的应用

Application of Low-dose Bupivacaine-fentary Combined with Spinal Spinal and Epidural Anethesia for Cesarean Section

目的探讨较小剂量布比卡因复合芬太尼腰硬联合麻醉行剖宫产术的临床效应。方法 40例行急诊剖宫产术的临产妇,随机双盲分为两组。A组腰麻用药为布比卡因6mg加芬太尼20μg（n=20）;B组布比卡因10mg（n=20）。观察两组用药后的MAP和HR变化、新先儿Apgar评分、麻醉效果及不良反应。结果 B组MAP比A组下降更加显著,B组低血压发生率明显高于A组（P〈0.01）;两组新生儿Apgar评分无差异（P〉0.05）;A组麻醉效果明显优于B（P〈0.01）;两组不良反应无显著差异。结论较小剂量布比卡因复合芬太尼腰硬联合麻醉行急诊剖宫产术,麻醉效果确切,低血压发生率低且不良反应少。

Objective To study the clinical effectiveness of lower-dose bupivacaine-fentanyl combined spinal and epidural anesthesia for cesaream section.Method In this randomized,double-blind study,40 parturient women were allocated to one of two groaps.Group A,receiving 6mg bupivacaine＋20μg fentanyl（n=20） and group B,10mg bupivacaine（n=20）.MAP,HR,Apgar scores of newborn,anesthetic effects and side effects were observed.Result The decrease of MAP was greater in group B compared with that in group A.The incidence of hypopiesia was higher in group B compared with that in group A（P0.01）.There was no significant difference in the Apgar scales of newborns between the two groups（P0.05）.The effect of anesthesia in group B was significanfly better than that in group A（P0.01）.There was no significant difference in the side effects between the two groups（P0.01）.Conclusion There are better effect of anesthesia and lower incidence of hypopiesia and fewer side effect in combined spinal and epidural anesthesia with lower-dose bupivacaine-fentanyl for urgent cesarean section.