不同比重布比卡因腰麻用于产科麻醉的临床对比观察

Different specific gravity of Bupivacaine for lumbar anesthesia in obstetrics

目的探讨不同比重布比卡因在产科麻醉中对产妇血压及胎儿宫内缺氧情况的影响。方法 400例行剖宫产术产妇分成Ⅰ、Ⅱ组各200例,均采用蛛网膜下隙与硬脊膜外联合阻滞麻醉(combined spinal epidural anesthesia,CSEA)。穿刺成功后分别注入0.5%布比卡因等比重液2 ml和重比重液2 ml,观察用药后产妇麻醉平面及血压脉搏变化。结果两组均避免了胎儿宫内缺氧,麻醉效果均满意。等比重布比卡因对产妇血压影响小,明显优于重比重布比卡因。不良反应发生率及麻黄碱的使用率Ⅰ组均低于Ⅱ组,差异有统计学意义(P<0.05)。结论 等比重布比卡因和重比重布比卡因用于产科麻醉均安全有效,但前者对产妇血压影响更小,不良反应更少。

Objective To investigate the blood pressure of lying-in women and intrauterine fetal anoxia in obstetrics anesthesia with Bupivacaine.Methods We randomly divided 400 patients undergoing cesarean section into two groups： 200 patients with isobaric Bupivacaine 2 ml（group I）,and the other 200 with hyperbaric Bupivacaine 2 ml（group II）.Combined spinal epidural anesthesia was performed in both two groups.Block height,blood pressure and heart rate were observed.Results The effect of anesthesia was satisfactory in both two groups without intrauterine fetal anoxia.Incidence of adverse reactions and ephedrine usage in group I were lower than those in group II,the differences were statistically significant（P0.05）.Conclusion It is safe and effective to use isobaric Bupivacaine and hyperbaric Bupivacaine in obstetrics anesthesia,but the former is better.