摘要
目的:研究不同剂量左布比卡因腰麻在剖宫产术中麻醉效果。方法:选择ASA1～2级剖宫产妇90例,年龄23～36岁,体重55～90kg,身高150～175cm,随机、双盲分成3组,每组30例,均采用腰硬联合麻醉,L2～3椎间隙穿刺,穿刺成功后蛛网膜下腔分别注入0.75%左布比卡因(加10%葡萄糖至2mL),A组(7.5mg)、B组(10mg)、C组(12.5mg),3组注药时间均为1mL/5s。给药后用针刺法测定感觉阻滞平面,给药15min后阻滞平面未达T6水平者经硬膜外分次酌情追加2%利多卡因。麻醉期连续监测BP、HR、ECG和SPO2,观察并记录给药后15min麻醉平面、麻醉效果、并发症的发生率及新生儿1min和5min的Apgar评分。结果:在麻醉效果、并发症的发生率及新生儿1min和5min的Apgar评分等方面B、C两组与A组比较无显著性差异(P>0.05);在麻醉平面,B、C两组与A组比较有显著性差异(P<0.05)。结论:左布比卡因B组(10mg)和C组(12.5mg)腰麻在剖宫产术中麻醉效果是有效的、安全的。
Objective： To investigate the effects of different doses of levobupivacaine on spinal anesthesia for cesarean section. Methods： Ninety pregnant women who had underwent ASA 1-2 cesarean section were randomized, double-blind divided into 3 groups, 30 cases of each group, aged 23 to 36 years old, weighing 55 - 90kg, height 150 - 175cm. Combined spinal-epidural anesthesia was used, patients underwent puncture at L2-3 intervertebral space, levobupivacaine （plus 10% glucose solution to 2 mL） was injected into subarachnoid with different doses for different groups after successful puncture, the dosage for group A, B and C was 7.5 mg, 10 mg and 12.5 mg respectively, the injection speed was 1 mL/5s. After administration, the block plane of feeling was determined using acupuncture ; if the block plane of feeling was lower than T6 level 15 min after administration, additional 2% lidocaine was injected epidurally according to different condition separately. BP, HR, ECG and SPO2 were monitored continuously during the anesthesia; the block plane of feeling 15 min after administration of anes- thetic drugs, anesthetic effect, the incidence of complications, and 1 min and 5 min Apgar score of the neonate were observed and recorded. Results： Of the anesthetic effect, the incidence of complications and 1 min and 5 min Apgar score of the neonate, the differences between group B, C and group A were not significant （ P 〉 0.05 ） ; of the anesthesia plane, the differences between group B, C and group A were significant （P 〈 0.05）. Conclusion ： Spinal anesthesia for cesarean section using 10 mg and 12.5 mg levobupivacaine were more effective and safer.
出处
《海南医学院学报》
CAS
2009年第9期1065-1067,共3页
Journal of Hainan Medical University
基金
广西卫生厅基金项目(NO.z2006211)~~
关键词
左布比卡因
麻醉
产科
剖宫产术
Levobupivacaine
Anesthesia
Obstetrical
Cesarean section
