小剂量轻比重布比卡因腰硬联合麻醉在剖宫产术中的应用

APPLICATION OF LITTLE VOLUME AND HYPOBARIC BUPIVACAINE USED IN COMBINED SPINAL AND EPIDUAL ANESTHESIA IN CAESAREAN SECTION

目的探讨小剂量轻比重布比卡因腰硬联合麻醉用于剖宫产术的效果。方法选择单胎孕足月产妇120例,ASAⅠ～Ⅱ级,随机分为三组:轻比重组(L组)、等比重组(D组)、硬膜外组(E组),每组40例,L组腰麻剂量0.1%布比卡因4ml,D组腰麻剂量0.5%布比卡因0.8ml,E组单纯硬膜外注2%利多卡因14～18ml,观察麻醉效果及围术期不良反应。结果麻醉起效时间、作用完全时间及镇痛效果L组与D组组间差异无统计学意义,但均优于E组(P<0.05)。不良反应发生率D组高于L组和E组,差异有统计学意义(P<0.05)。L组下肢运动神经功能恢复时间快于E组和D组,且与D组比较差异有统计学意义(P<0.01)。结论小剂量轻比重布比卡因腰-硬联合麻醉用于剖宫产术,起效快、作用完善,血流动力学稳定,更具有下肢运动神经功能恢复快的优点,值得临床推广应用。

Objective To study the effect of little volume and hypobaric bupivacaine in combined spinal and epidual anesthesia in caesarean section. Methods One hundred and twenty pregnant women were randomly divided into three groups., hypobric group（L group）, hyperbaric group（D group）, epidual group（E group）, （n = 40 each）. The spinal dosage of L group was 0.1% bupivacaine 4ml, D group with 0.5 % bupivaeaine 0.8ml and E group with injected （14- 18ml）to epidual cavity only with 2% lidocaine. The outcomes and the adverse reactions were observed. Results There was no significant differences in analgesic effect or the onset of the sensory nerve between L group and D group, but they had more advantages than E group（P〈0.05）. There was significant difference in the last time of the motor never block between L group and D group（P〈0.01）. Conclusion The application of little volume and hypobaric bupivacaine in combined spinal and epidual anesthesia in caesarean section has advantages of less mobil nerves block and fewer complications.