不同剂量等比重0.5%布比卡因腰麻在剖宫产手术中的效果比较(1)
[摘要] 目的 比较等比重的0.5%布比卡因7.5、10、12.5 mg腰麻行剖宫产手术的临床效果。 方法 将2015年4月—2016年4月该院腰硬联合麻醉下行剖宫产手术的患者300例，随机分成3组，每组100例、ASAI～II级。于L3-4间隙穿刺成功后向蛛网膜下腔注入0.5%布比卡因A组7.5 mg、B组10 mg、C组12.5 mg，硬膜外腔置管备用。比较3组麻醉起效时间、麻醉效果、寒战反应发生率、恶心呕吐、血管活性药物的使用、术中血流动力学变化及新生儿Apgar评分情况。结果 3组均取得良好的麻醉效果A组达到98%、B、C两组都达到99%，硬膜外补充用药后麻醉效果都达到手术要求，新生儿Apgar评分均满意，麻醉起效时间相当A组(5.6±1.6)min、B组(5.4±1.3)min、C组(5.2±1.0)min，但A组术中血流动力学更稳定(低血压发生率A组10%、B组32%、C组47%)、寒战(A组8%、B组16%、C组18%)及恶心(A组8%、B组19%、C组28%)、呕吐(A组4%、B组16%、C组25%)的发生率也低于B组和C组。结论 0.5%布比卡因等比重液7.5 mg腰麻行剖宫产手术具有较好的麻醉效果和安全性。
[关键词] 腰-硬联合麻醉；等比重布比卡因；剖宫产术；不同剂量
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2016)10(c)-0007-04
[Abstract] Objective Comparison of the clinical effect of isobaric bupivacaine 0.5% 7.5 mg，10 mg，12.5 mg spinal anesthesia for caesarean operation. Methods In April 2015 to April 2016 our waist hard joint anesthesia downlink cesarean section surgery of 300 cases of patients，Randomly divided into 3 groups，100 cases in each group、ASA I to II.Puncture success in L3-4 clearance after injected into subarachnoid space than paid 0.5% bupivacaine ， A group 7.5 mg， group B 10 mg， group C 12.5 mg，Epidural cavity catheter. Set aside.Compare three groups of anesthesia work time、Anesthesia effect、Chills reaction rates、Nausea and vomiting、The use of vasoactive drugs、Intraoperative hemodynamic change and neonatal Apgar score. Results Three groups has achieved good results，98% of group A， B， C in the two groups are up to 99%，Epidural drug anesthesia effect after all meet the operation requirements，Neonatal Apgar score were satisfied，Anesthesia work time(5.6 ± 1.6) min group A， group B(5.4 ± 1.3) min， group C(5.2 ± 1.0) min，But A group of intraoperative hemodynamic more stable(The incidence of hypotension in group A was 10%、group B 32%， group C 47%)、Chills (group A 8% and group B 16%， group C 18%)and the incidence of nausea (group A 8% and group B 19%， group C 28%)and emesis(group A4% and group B 16%， group C 25%) are lower than that of group B and group C.Conclusion With the anesthetic effect and safety of good 0.5% isobaric bupivacaine solution 7.5 mg spinal anesthesia for caesarean operation.
[Key words] Vaist-epidural；Anesthesia；Isobaric；Bupivacaine；Cesarean section；Different doses
近年来，腰硬联合麻醉因其能够提供良好的镇痛与肌松，并且起效快、操作简单，术中可以追加麻醉药达到很好的手术效果，且不良反应小、并发症少，被广泛应用于剖宫产手术中。但是对布比卡因的最适合用药量，很多文献报道不一。该院于2015年4月—2016年4月选择了300例腰硬联合麻醉下行剖宫产手术的患者，比较不同剂量的0.5%布比卡因等比液的麻醉效果、血流动力学的稳定性及并发症的发生率，总结出最适合基层医院的相对安全的麻醉剂量，具有较高的临床应用价值，现报道如下。
1 资料与方法
1.1 一般资料 (陈东 彭程 吴荆棘)
[关键词] 腰-硬联合麻醉；等比重布比卡因；剖宫产术；不同剂量
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2016)10(c)-0007-04
[Abstract] Objective Comparison of the clinical effect of isobaric bupivacaine 0.5% 7.5 mg，10 mg，12.5 mg spinal anesthesia for caesarean operation. Methods In April 2015 to April 2016 our waist hard joint anesthesia downlink cesarean section surgery of 300 cases of patients，Randomly divided into 3 groups，100 cases in each group、ASA I to II.Puncture success in L3-4 clearance after injected into subarachnoid space than paid 0.5% bupivacaine ， A group 7.5 mg， group B 10 mg， group C 12.5 mg，Epidural cavity catheter. Set aside.Compare three groups of anesthesia work time、Anesthesia effect、Chills reaction rates、Nausea and vomiting、The use of vasoactive drugs、Intraoperative hemodynamic change and neonatal Apgar score. Results Three groups has achieved good results，98% of group A， B， C in the two groups are up to 99%，Epidural drug anesthesia effect after all meet the operation requirements，Neonatal Apgar score were satisfied，Anesthesia work time(5.6 ± 1.6) min group A， group B(5.4 ± 1.3) min， group C(5.2 ± 1.0) min，But A group of intraoperative hemodynamic more stable(The incidence of hypotension in group A was 10%、group B 32%， group C 47%)、Chills (group A 8% and group B 16%， group C 18%)and the incidence of nausea (group A 8% and group B 19%， group C 28%)and emesis(group A4% and group B 16%， group C 25%) are lower than that of group B and group C.Conclusion With the anesthetic effect and safety of good 0.5% isobaric bupivacaine solution 7.5 mg spinal anesthesia for caesarean operation.
[Key words] Vaist-epidural；Anesthesia；Isobaric；Bupivacaine；Cesarean section；Different doses
近年来，腰硬联合麻醉因其能够提供良好的镇痛与肌松，并且起效快、操作简单，术中可以追加麻醉药达到很好的手术效果，且不良反应小、并发症少，被广泛应用于剖宫产手术中。但是对布比卡因的最适合用药量，很多文献报道不一。该院于2015年4月—2016年4月选择了300例腰硬联合麻醉下行剖宫产手术的患者，比较不同剂量的0.5%布比卡因等比液的麻醉效果、血流动力学的稳定性及并发症的发生率，总结出最适合基层医院的相对安全的麻醉剂量，具有较高的临床应用价值，现报道如下。
1 资料与方法
1.1 一般资料 (陈东 彭程 吴荆棘)