国产3%氯普鲁卡因硬膜外阻滞剖宫产术的临床研究

Epidural Anesthesia with 3% Chlorprocaine Hydrochloride in Caesarean Section

目的 :评估 3%氯普鲁卡因硬膜外麻醉剖宫产手术的临床效果和耐受性。方法 :6 0例剖宫产术患者 (ASAⅠ Ⅱ级 )硬膜外麻醉 ,随机分为 3%氯普鲁卡因组 (实验组 ) 30例 ,2 %利多卡因组 (对照组 ) 30例。取L1～ 2 行硬膜外穿刺 ,向头端置管 3cm分别注入 3%氯普鲁卡因或 2 %利多卡因 3ml试验量 ,5min后再注入 12ml。结果 :实验组感觉、运动阻滞起效时间均快于对照组 (P <0 .0 5 )、最高阻滞平面中位数高于对照组 ,感觉、运动阻滞恢复时间两组一致 (P >0 .0 5 )。实验组Bromage评分高于对照组 (P <0 .0 1)。实验组在切皮、剪切腹膜及分娩时镇痛效果优于对照组 (P <0 .0 5 )。无严重不良反应。结论 :国产3%氯普鲁卡因用于硬膜外麻醉剖宫产手术时其感觉、运动阻滞及镇痛效果优于 2 %利多卡因。

Objective: To evaluate the clinical effect and tolerability of 3% chlorprocaine hydrochloride versus 2% lidocaine in epidural anesthesia in patients undergoing caesarean section. Methods: Sixty parturients(ASAⅠ-Ⅱ) were randomly designed to receive 3% chlorprocaine hydrochloride (test group, n=30) or 2% lidocaine(control group,n=30) epidural anesthesia respectively during caesarean section. In all patients epidural space L 1-2 was selected, then the catheter was put 3 cm upward. Five minutes after 3 ml anesthetic test volume into epidural space, a bolus of 12 ml anesthetic volume was given to each patient. Results:The onset time of both feeling and motor block in test group was shorter (P<0.05) than that in control group, The median of maximum cephalad sensory was higher with chlorprocaine hydrochloride than that with lidocaine. The onset time of feeling and motor block recovery was similar in both groups(P>0.05). Bromage score of the test group was higher than that of the control group (P<0.01). The test group was better than the control group in hull peritoneum slice and during delivery. No severe adverse effect was found during the observations. Conclusion: 3% chlorprocaine hydrochloride provides a better sensory block intraoperative analgesia than 2% lidocaine when used epidurally in patients undergoing caesarean section.