轻比重与重比重布比卡因腰麻在剖宫产术中的作用比较

Comparison between intrathecal hypobaric bupivacaine and hyperbaric bupivacaine for caesarean section

目的 对 0 .12 5 %轻比重布比卡因与 0 .5 %重比重布比卡因腰麻在剖宫产术腰麻 -硬膜外联合麻醉( CSEA)应用中的麻醉效果及并发症进行比较。方法 随机选择 6 0例拟行剖宫产手术的产妇 ,平均分为两组 ,均采用 CSEA麻醉方法。分别向蛛网膜下腔注射 0 .5 %重比重布比卡因 1ml(重组 )与 0 .12 5 %轻比重布比卡因 4m l(轻组 )。结果 重组起效时间明显比轻组短 ,腰麻后 15分钟麻醉平面高于轻组 ( P均 <0 .0 1)。轻组 2 %利多卡因用量显著多于重组 ( P<0 .0 5 )。低血压发生率 :重组 43.3% ,轻组 16 % ;恶心呕吐发生率 :重组 2 6 .7% ,轻组 6 .7% ,具有显著性差异。轻组的腰麻平面消退较重组快 ( 33.4分钟对 6 1.7分钟 )。结论 轻比重药液与重比重药液相比更具有对下肢运动神经阻滞轻、对循环影响小的特点。

Objective Evaluating the effectiveness and complications by use of intrathecal injection of hypobaric and hyperbaric bupivacaine for caesarean section.Methods Sixty term parturients were randomly divided into one of two groups and intrathecally recieved either:hypobaric group with 1ml of 0.125% bupivacaine and hyperbaric group with 4ml of 0.5% bupivacaine.Results The onset time of hyperbaric group was shorter and level of spinal anesthesia was higher than hypobaric group ( P <0.05 or P <0.01).The incidence of hypotension and nausea/vomitting was higher in hyperbaric groups ( P <0.05).Conclusions The combined spinal epidural technique,using hypobaric bupivacaine had advantages of less mobile nerves block and fewer complications than using hyperbaric bupivacaine.