摘要
目的 :观察小剂量布比卡因腰麻对腹膜外剖宫产手术麻醉的可行性、产妇血流动力学和新生儿Apgar评分的影响 .方法 :选择行腹膜外剖宫产手术的产妇 2 0 0名 ,随机均分为两组 ,每组 10 0名 .布比卡因腰麻组 (spinalanesthesiawithbupivacaine ,SA) :在腰 2~ 3间隙穿刺 ,以重比重 (含葡萄糖 8g·L-1)布比卡因 0 12mg·kg-1进行腰麻 .硬膜外腔麻醉组(epiduralanesthesia,EA) :在腰 1~ 2间隙穿刺 ,以 2 0 0 g·L-1盐酸利多卡因和 7 5 g·L-1盐酸布比卡因进行麻醉维持 .观察两组产妇的血流动力学变化、新生儿apgar评分及腰麻后并发症的发生情况 ,比较两组麻醉的起效时间、胎儿剖出时间、局麻药用量和术后产妇麻醉恢复时间 .结果 :SA组产妇的麻醉起效快 (P <0 0 1) ,胎儿剖出时间快 (P <0 0 5 ) ,局麻药用量小 (P <0 0 0 1) ,且腰麻后并发症较少 ,显著优于EA组 .两组产妇的血流动力学变化、产妇术后麻醉恢复时间和新生儿的apgar评分基本相似 (P >0 0 5 ) .结论 :小剂量布比卡因腰麻用于腹膜外剖宫产手术麻醉是安全可行的 。
AIM: To evaluate the application of s pinal anesthesia with a small dose of bupivacaine in caesarean section and its e ffects on hemodynamic in parturients and Apgar scores of neonates. METHO DS: 200 parturients undergoing caesarean section were randomly divided i nto two groups (n=100,in each group). In group SA (spinal anesthesia with bupiv acaine) 0.12 mg·kg -1 of bupivacaine was used through 2-3 interlumbar vert ebrae. In group EA (epidural anesthesia) 20 0 g·L -1 lidocaine and 7 5 g ·L -1 bupivacaine were used via epidural catheter through 1-2 interlumbar vertebrae. The hemodynamic changes in parturients and neonatal Apgar scores were recorded. The onset time, the neonate delivery time, the total dose of local an esthetics, recover time of anesthesia and the complications of spinal anesthesia were compared between the two groups. RESULTS: The onset time o f SA was shorter (P<0 01), the neonate delivery time wa s more quickly (P<0 05) and its total dose of local ane sthetics was smaller ( P< 0 001), which were signific antly better than those of EA. No obvious complications were found in parturient s with spinal anesthesia. The hemodynamic changes in parturients, recover ti me o f anesthesia and neonatal Apgar scores were similar between the two groups(P>0 05). CONCLUSION: The clinical ap plication of spinal anesthesia with a small dose of bupivacaine in caesarean sec tion is safe and effective.
出处
《第四军医大学学报》
北大核心
2003年第2期126-128,共3页
Journal of the Fourth Military Medical University
关键词
布比卡因
腰麻
腹膜外剖宫产
临床观察
bupivacaine
anesthesia,spinal
anesthesia,e pidural
spinal,cesarean section