摘要
目的探讨小剂量左旋布比卡因腰硬联合麻醉在急诊剖宫产手术中的临床效果。方法剖宫产手术112例,ASAⅠ～Ⅱ级,年龄20～37岁,按照随机对照表随机分为两组,每组56例。A组(试验组)为小剂量腰硬联合麻醉组,B组为硬膜外麻醉组,观察两组的血流动力学变化(平均动脉压、心率、血氧饱和度)、VAS疼痛评分、肌松效果、新生儿出生后1min、5min Apgar评分、两组最高阻滞平面及并发症等。结果阻滞前后及两组间血流动力学差异均无统计学意义,术中A组低血压发生率为10.7%,麻黄素使用率为5.3%,与B组比较差异有统计学意义。两组最高阻滞平面、不良反应及术后新生儿Apgar评分差异无统计学意义,但A组镇痛效果完全,有效镇痛持续时间长,肌松效果好,显效快,最高阻滞平面到达时间短,与B组比较有显著差异。结论小剂量左旋布比卡因腰硬联合麻醉用于急诊剖宫产手术,对血流动力学影响较小,术后患者能及早运动,镇痛完全,有效镇痛持续时间长,肌松效果好,起效快,是一种较为合理的麻醉选择。
Objective To evaluate clinical efficacy of lowdose levobupivacaine during combined spinalepidural anesthesia（CSEA）in caesarean section. Methods 112 ASA1-2 parturients undergoing caesarean section were randomized into A group and B group（n=56, in each group,ages 20 -37）.CSEA was performed at L2-3 or L3-4 with low-dose B upivacaine on group A,only block epidural （EA）was performed at L1 N 2 or L2- 3with lidocaine on group B.Observe two group hemodynamie variables（MAP, HR,SpO2）,postoperation VAS scales,the top blockade level,neonatal Apgar scores and side effects. Results There was no significantly differences between two groups in hemodynamics.To compare two groups on start effect time,degree of muscle relaxation,the times of the height of block appearance,the anesthesia effect,three patients（5.3%）in A group and one patient（2.0%）in B group required ephedrine to correct hypoten- sion,postoperation effective analgesia duration was evidently prolong in A group.Postoperation VAS scores,the top blockade level,neonatal Apgar scores and in the incidence of side effects.The times of group A decreased significantly and anesthesia effect was better. Conclusion Lowdose levobupivaeaine during CSEA in caesarean section is a reasonable anesthesia.
出处
《中国现代医生》
2010年第21期96-97,111,共3页
China Modern Doctor
关键词
左旋布比卡因
腰硬联合麻醉
剖宫产
Levobupivacaine
Spinalepidual anesthesia
Caesarean section
