摘要
目的：观察不同比重布比卡因对腰麻-硬膜外联合麻醉（combined spinal epidural anesthesia,CSEA）行剖宫产产妇神经功能的影响。方法：180例ASAⅠ-Ⅱ级产妇于腰麻一硬膜外联合麻醉下行剖宫产手术,随机分为3组：1组60例为轻比重组,腰麻用药为0.75%布比卡因1.2ml加生理盐水至2.4ml;2组60例为等比重组,腰麻用药为0.75%布比卡因1.2ml脑脊液稀释至2.4ml,3组60例为重比重组,腰麻用药为0.75%布比卡因1.2 ml加50%葡萄糖0.3 ml,脑脊液稀释至2.4 ml。如有阻滞不全经硬膜外导管注入2%利多卡因。观察术中麻醉效果,术后第1、3、5天以问卷形式询问产妇主诉包括感觉及运动恢复时间,特别是神经症状如头痛、臀以下麻木或疼痛以及新出现的腰背痛。术后是否有单侧或双侧臀或下肢疼痛、异常感觉、迟钝或异常性疼痛。结果：3组产妇术后下肢感觉及运动功能恢复时间有显著差别（P〈0.05）,轻比重组恢复时间最短,但麻醉阻滞不全发生率最高。重比重组一过性神经症状发生率高于其他两组（P〈0.05）。结论：0.375%布比卡因等比重液用于腰硬联合麻醉剖宫产手术效果确切,对产妇神经功能影响较小。
Objective： To observe the effects of bupivacaine at different specific gravity on the nervous function in patients undergoing cesarean section with combined spinal and epidural anesthesia （CSEA） . Methods： One hundred and eighty puerperants （ASAⅠ-Ⅱ） were randomly divided into： group Ⅰ （ n = 60） were injected intrathecally hypoharic hupivacaine for spinal anesthesia; group Ⅱ （ n = 60） received 2. 4 ml of 0. 75% isotonic specific gravity bupivacaine; group Ⅲ（ n = 60） received 2. 4 ml of 0. 75% hyperbaric gravity bupivaeaine. 2% lidocaine was supplemented via epidural catheter if necessary. Results： There was significant difference among three groups in recovery time of sensory and motor function （ P 〈 0. 05）, group I had shorter recovery time but higher incidence of additive 2% lidocaine, incidence of sensory disability was higher in group Ⅲ than that in other two groups. Conclusion： 0. 375% isobaric gravity bupivacaine has little effect on nervous function than that of 0. 75% hyperbaric bupivacaine.
出处
《中国妇幼保健》
CAS
北大核心
2007年第20期2866-2867,共2页
Maternal and Child Health Care of China
关键词
布比卡因
腰麻硬膜外联合麻醉
剖宫产
神经功能
Bupivacaine
Combined spinal and epidural anesthesia （CSEA）
Cesarean section
Nervous function
