摘要
目的观察对比不同比重左布比卡因腰麻在妇科手术患者中的应用。方法 60例妇科手术患者随机分为3组,均取侧卧位,以L_(2～3)为穿刺间隙,使用国产腰-硬联合麻醉穿刺包。穿刺成功后注入预先配置好的局部麻醉药,重比重组0.75%左布比卡因2 mL+10%葡萄糖注射液1 mL,等比重组0.75%左布比卡因2 mL+灭菌注射用水1 mL,轻比重组0.75%左布比卡因2 mL+灭菌注射用水4 mL,硬膜外置管备用。观察3组感觉、运动阻滞情况和镇痛效果等。结果轻比重组感觉及运动阻滞起始时间长于重比重组(P<0.05),与等比重组比较无显著差异(P>0.05),感觉及运动阻滞持续时间短于其他2组(P<0.05)。3组患者麻醉后VAS评分无显著差异(P>0.05)。血压均有下降趋势,其中重、等比重组麻醉后5 min与麻醉前相比差异均有显著意义(P<0.05),轻比重组麻醉后5 min血压与麻醉前比较无显著差异(P>0.05)。结论轻比重左布比卡因腰麻患者感觉和运动恢复较快,更适用于妇科手术。
AIM To observe and contrast the effects of different specific gravity of levobupivacaine in spinal anesthesia during gynecological surgery. METHODS Sixty patients were divided randomly into 3 groups, and subjected to spinal puncture in lateral position between spinous processes at L2-3 levels using domestic combined spinal and epidural anesthesia （CSEA） puncture bag. After lumbar puncture, the patients in the hyperbaric group were received 2 mL of 0.75% levobupivacaine and 1 mL of 10% glucose injection. The patients in the isobaric group were received 2 mL of 0.75% levobupivacaine and 1 mL of sterile water for injection. The patients in the hypobaric group were received 2 mL of 0.75% levobupivacaine and 4 mL of sterile water for injection. Analgesic effects, sensory and motor block were observed. RESULTS The onset time of sensory and motor block in the hypobaric group was similar to that in the middle group （P 〉 0.05）, but longer than that in the hyperbaric group （P 〈 0.05） . The duration of the sensory and motor block in the hypobaric group was significantly shorter than those in the other two groups （P 〈 0.05）. There was no significant difference in VAS score among three groups （P 〉 0.05）. Blood pressure 5 min after anesthesia were higher that that before anesthesia in hyperbaric and isobaric groups （P 〈 0.05）, with no significant difference in the hypobaric group （P 〉 0.05）. CONCLUSION The hypobaric levobupivacaine in spinal anesthesia results in a faster recovery of sensory and motor function, and is more suitable for gynecological surgery.
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2010年第7期541-543,共3页
Chinese Journal of New Drugs and Clinical Remedies
关键词
左布比卡因
麻醉
脊椎
妇科外科手术
levobupivacaine
anesthesia, spinal
gynecologic surgical procedures
