不同比重布比卡因腰麻液用于剖宫产手术的比较(1)
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【摘要】目的 比较0.5%重比重与等比重布比卡因腰麻液在剖宫产手术中的麻醉效果及对产妇血流动力学的影响。方法 选择200例ASA分级Ⅰ～Ⅱ级的剖宫产患者，随机分为两组: 等比重组(A组)：腰麻用药为0.75%布比卡因2 ml 加生理盐水1 ml稀释至3ml后注入1.5ml；重比重组(B组)：腰麻用药为0.75%布比卡因2 ml加10%葡萄糖注射液1ml稀释至3ml 后注入1.5 ml。分别记录腰麻起效时间、达到最高平面所需时间、最高镇痛平面、需要静脉辅助药情况及产妇的SBP、DBP、HR的变化，并记录新生儿Apgar评分情况。结果 B组发生低血压和恶心呕吐的例数明显多于A组(P<0.05)； B组的达到最高阻滞平面的时间短于A组，阻滞平面也高于A组(P<0.05)，两组均取得良好的麻醉效果。两组新生儿1min 、5 min的Apgar评分比较差异无统计学意义(P>0.05)。结论 0.5%布比卡因等比重液用于腰-硬联合麻醉行剖宫产手术更平稳，母婴更安全。
【关键词】剖宫产 腰麻 布比卡因 等比重 重比重
中图分类号：R614 文献标识码：B 文章编号：1005-0515(2012)1-227-03
Comparison of different specific gravity of bupivacaine on spinal anesthesia for cesarean section
YANG Fang YANG Wangmin XING Tanghui
(Department of Anesthesiology，Dalian Obstetrics and Gynecology Hospital)
【Abstract】Objective comparison of anesthetic effect on spinal anesthesia for cesarean section with weigh proportion and isobaric 0.5%bupivacaine and the effect on maternal hemodynamics. Methods 200 cases of ASA I-II grade of cesarean section patients, were randomly divided into two groups: the group of isobaric ( group A): 1.5ml bupivacaine with normal saline solution was injected into subarachnoid.The group of weigh proportion( group B):1.5ml bupivacaine with 10% glucose was injected into subarachnoid. Recorded the onset time of spinal anesthesia，the time of reaching the highest level, the maximum analgesia plane, requiring intravenous adjuvant . the changes of maternal SBP, DBP, HR, and Apgar score of the neonate were recorded. Results the incidence of hypotension and nausea and vomiting in group B the number of cases significantly more than those in group A ( P < 0.05 ); the time of the maximum block plane in group B was shorter than in group A, block level is higher than that of A group ( P < 0.05 ), of the anesthetic effect, and 1 min and 5 min Apgar score of the neonate, the differences between the two groups were not significant(P>0.05); Conclusion 0.5% isobaric bupivacaine for combined spinal-epidural anesthesia on cesarean section were more stable and more safer for mother and child ......
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