不同比重布比卡因腰麻在剖宫产术中的临床观察

The clinical effects of different bupivacaine for lumbar anesthesia cesarean section

目的观察等比重与重比重两种不同的布比卡因在腰麻下行剖宫产术的临床效果。方法选择ASA分级Ⅰ～Ⅱ级拟行剖宫产手术病例80例,随机分为等比重组I组和重比重组H组各40例。均采用单纯腰麻技术,经L3～4行腰麻穿刺,穿刺成功后,注入0.5%布比卡因2 mL,观察两组注药后5 min、10 min平均动脉压(MAP)及心率的变化;最高麻醉平面、麻醉完全起效时间及并发症。结果两组均取得良好的麻醉效果,蛛网膜下腔注药后两组均出现血压下降、心率升高,H组血流动力学变化较I组变化大而且出现早。麻醉完全起效时间H组较I组早且并发症多。结论等比重布比卡因腰麻在剖宫产手术过程中麻醉平稳,产妇安全舒适,不良反应更少。

Objective To compare the application clinical effects of isobaric and hyperbaric solution ot buplvacaine for lumbar anesthesia cesarean section and to provide reference. Methods We randomly divided 80 patients undergoing ce- sarean section into two groups： 40 patients with isobaric Bupivacaine 2 mL （group I）, and the other 40 with hyperbaric bupi- vacaine 2 mL（group H）. Combined spinal epidural anesthesia was performed in both two groups observation of two groups of 5 minutes after the injection of medicine 10 minute mean arterial pressure （MAP） and heart rate changes; Highest plane of anesthesia, anesthesia full onset and complications. Results Both groups had achieved good effect of anesthesia, sub- arachnoid note medicine after two groups all appear blood pressure droped, heart rate increased, hemodynamic changes in group H was big and appeared earlier than I group. Anesthesia completely effective time in H group was ealier than I group and had more complications than in I group. Conclusion Isobaric bupivacaine in spinal anesthesia for Cesarean process smooth, maternal safety, comfort, less adverse reactions.