摘要
目的探讨左布比卡因蛛网膜下腔阻滞麻醉用于剖宫产术中的最佳剂量。方法选取本院收治的择期子宫下段剖宫产术患者63例,美国麻醉师协会(ASA)Ⅰ~Ⅱ级,采用随机数字表法分为A、B、C 3组,每组各21例。3组均选取L2~3或L3~4间隙穿刺,注射5%左布比卡因行蛛网膜下腔阻滞麻醉(后简称腰麻),A组给药10mg,B组给药12.5mg,C组给药15mg,记录3组患者最高阻滞平面、达到阻滞平面时间,记录镇痛不全、肌松不全、牵扯反应及并发症发生率,统计麻醉前(T0)、麻醉1min(T1)、5min(T2)、10min(T3)、15min(T4)、30min(T5)平均动脉压(MAP)、心率(HR)。结果 B、C组最高阻滞平面高于A组,达到阻滞平面时间短于A组,差异有统计学意义(P<0.05),且B组阻滞平面时间与C组比较,差异有统计学意义(P<0.05);3组不同时间点HR比较,差异无统计学意义(P>0.05);与T0点比较,3组T3、T4点MAP均下降,且C组下降较A组、B组明显,差异有统计学意义(P<0.05),A组、B组组间比较差异无统计学意义(P>0.05);A组镇痛不全、肌松不全、牵扯反应略高于B组、C组,但3组比较差异无统计学意义(P>0.05);3组恶心呕吐、心动过缓、呼吸抑制的发生率比较,差异无统计学意义(P>0.05);B组低血压发生率低,与A组、C组比较,差异有统计学意义(P<0.05)。结论 5%左布比卡因12.5mg既可保证理想的麻醉效果和阻滞平面,维持术中血流动力学稳定,又可最大限度的减少不良反应发生。
Objective To investigate the optimal dose of levoupivacaine for subarachnoid block anesthesia in cesarean section. Methods Sixty-three women underwent elective lower uterine segment cesarean section in our hospital, ASA Ⅰ-Ⅱ, were divided into three groups by random number table method, 21 cases in each group. The three groups were given subarachnoid block anesthesia （lumbar anesthesia） at L2-3 or L3-4 puncture space. Group A was given 10mg of 0.5% levoupivacaine. Group B was given 12.5rag of 0.5% levoupivacaine. Group C was given 15rag of 0.5% levoupivacaine. The highest block plane and time to block plane of the three groups were recorded. The incidence rates of incomplete analgesia, incomplete muscle relaxation, dragging reactions and complications were also recorded. The mean arterial pressure （MAP） and heart rate （HR） were statistically analyzed before anesthesia （TO）, after lmin （T1）, 5min （T2）, 10rain （T3）, 15rain （T4） and 30rain （TS） of anesthesia. Results The highest block plane of group C and group 13 was higher than that of group A, and the time to block plane was shorter than that of group A （P〈0.05）, but there was no significant difference between group B and group C （P〉 0.05）. There was no significant difference among the three groups in HR at different time points （P〉0.05）. Compared with T0, MAP were decreased in the three groups at T3 and T4, and the decrease in group C was more significant than that in group A and group B （P〈0. 05） but there was no significant difference between group A and group B （P〉0.05）. The incidence rates of incomplete analgesia, incomplete muscle relaxation and dragging reactions in group A were slightly higher than those in group B and group C, but there were no significant differences among the three groups （P〉0.05）. There were no significant differences among the three groups in the incidence rates of nausea and vomiting, bradyeardia and respiratory depression （P〉0.05） ; The incidence of hy
作者
罗丽
许斌兵
江继端
张敏
王珺
LUO Li;XU Binbing;JIANG Jiduan;ZHANG Mini;WANG Jun(Department of Anesthesiology, Suining Central Hospital, Suining 629000, Sichuan , China;Department of Anesthesiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan, China)
出处
《西部医学》
2018年第6期872-875,共4页
Medical Journal of West China
基金
四川省科技厅科研课题(20124JY061)
