不同剂量等比重布比卡因腰麻用于剖宫产手术的临床观察

Clinical Observation on Different Dose Proportion Cloth than Kayin Desert Hemp Used for Cesarean Section Surgery

目的观察不同剂量等比重布比卡因腰麻用于剖宫产手术的麻醉效果、并发症,并探讨其安全性。方法剖宫产手术患者200例,ASAI^II级,随机分为两组,蛛网膜下腔注入0.75%布比卡因2.0 ml(A组)和注入0.75%布比卡因1.6 ml(B组)。监测并记录两组产妇麻醉前(T1),注药后5 min(T2),取出胎儿后(T3),缝合腹膜时(T4)的平均动脉压(MAP)、心率(HR)和血氧饱和度(SPO2),记录两组产妇感觉阻滞起效时间、感觉阻滞最高平面、运动阻滞起效时间、运动阻滞和感觉阻滞恢复时间。记录两组产妇阻滞后低血压、心动过缓发生率和术中牵拉反应。结果两组产妇年龄、体重、身高和孕龄等一般情况差异均无统计学意义。T2时A组MAP明显低于T1时和B组,HR明显快于T1时和B组(P<0.05)。两组SPO2组间组内差异无统计学意义。B组感觉阻滞起效时间和运动阻滞起效时间明显长于A组(P<0.05)。A组感觉阻滞平面明显高于B组(P<0.05)。B组低血压、心动过缓、恶心呕吐、呼吸困难、牵拉反应和心动过缓等不良反应发生率明显低于A组(P<0.05)。结论 0.75%布比卡因1.6 ml腰麻用于剖宫产手术不仅能满足手术需求,与0.75%布比卡因2.0 ml用于脊麻相比,安全性更高。

bstract OBJECTIVE To observe different doses, such as proportion of cloth than kayin spinal anesthesia for cesarean section surgery anesthesia effect, complications and its security is discussed. METHOD 200 cases of cesarean section surgery patients, ASAI, class II, were divided into two groups randomly, subarachnoid injection 0.75% of cloth than paid 2.0 ml（group A）and injection of 0.75% than paid 1.6 ml（group B）. Monitor and record the two groups before anesthesia（T1）, medicine for 5 minutes after injection （T2）, remove the fetus（T3）, after suturing peritoneum（T4）when MAP, HR, SPO2, record working time two groups of maternal sensory blockade, maximum sensory block plane, and motor anesthesia work time, motion block and sensory block recovery time. Record hypotension after two groups of blocks, incidence and intraoperative bradycardia force response. RESULTS Two groups of maternal age, weight, height, and gestational age, etc. In general, differences were not statistically significant. T2 MAP significantly lower than group A, while HR is obviously faster than the T1 and group B（P〈0.05）. Two groups of SPO2 there was no statistically significant difference within the group. Group B sensory blockade effect and motor blockade working time significantly than group A（P〈0.05）. Sensory blockade plane A group was obviously higher than that of group B（P〈0.05）. Group B hypotension, bradycardia, nausea and vomiting, difficulty breathing, pull reaction and TNS, the incidence of adverse reactions was lower than that in group A（P〈0.05）. CONCLUSION 0.75% cloth than paid 1.6 ml spinal anesthesia for cesarean section surgery not only can meet the demand, and 0.75% than paid compared to 2 ml for spinal anesthesia, safety is higher.