摘要
[目的]比较椎管内麻醉三种不同给药方式用于剖宫产术的麻醉效果.[方法]择期60例剖宫产产妇,随机分为A,B,C三组,每组20例,A组腰麻用量0.5%布吡卡因重比重液3 mL（15 mg）,B组0.5%布吡卡因重比重液2 mL（10 mg）＋硬膜外充填（0.25%布吡卡因10 mL）,C组0.5%布吡卡因重比重液7.5 mg（1.5 mL）＋芬太尼20 μg.检测并记录基础值（T1）、麻醉后1 min（T2）、麻醉后5 min（T3）、手术结束时（T4）的平均动脉压、心率变化,运动阻滞程度及平面消退时间.[结果]与T1相比,T2时三组用药后的MAP均有不同程度的下降（P〈0.05）,T2 、T3时组间比较A组MAP比B、C组下降更加显著（P〈0.01）,B、C组间MAP变化差异无统计学意义（P〉0.05）.A组bromage评分大于B、C组（P〈0.05）,A组平面消退时间较B、C组明显延长（P〈0.01）,但B,C组间比较无明显差异（P〉0.05）.[结论]布吡卡因10 mg加硬膜外容量扩充和7.5 mg加芬太尼这两种给药方法对患者血流动力学影响小,肌松效果良好,值得临床推广.
[Objective] To explore the effect of three methods of spinal canal anesthesia for cesarean section on the anesthesia efficacy of parturients. [Methods] Sixty parturients undergoing cesarean section were randomly divided into Group A, B and C with 20 cases in each. Group A was given 3mg（15mg） 0.5% hyper- baric bupivacaine. Group 13 was given 2mL（10mg） 0.5%hyperbaric bupivacaine and epidura[ filling of 10mL 0. 25% bupivacaine. Group C was given 7. 5mg（1. 5mL） 0. 5% hyperbaric bupivacaine and 20ug fentanyl. Mean arterial pressure（MAP）, heart rate（HR）, the degree of motion block and the regression time of the level at basic value（T1）, lmin afler anesthesia（T2 ） , 5min after anesthesia（T3 ） and the end of the operation（T4 ） were detected and recorded. [Results] Compared with T1, MAP at T2 after anesthesia in three groups decreased with a certain extent（ P〈0.05）. MAP at T2 and Ta in group A decreased more significantly than that in Group B and C（ P〈0.01）, but there was no significant difference between Group B and C（ P 〉0.05）. The bromage score in Group A was higher than that in Group B and C（ P〈0.05）. The regression time of the level in Group A was longer than that in Group B and C（ P〈0.01）, but there was no obvious differences between Group B and C（ P 〉0.05）. [Conclusion] The two methods of the medication such as10mg bupivaeaine combined with epidural filling, 7.5mg bupivacaine combined with 20ug fentanyl have little effect on hemodynamics and good effect on muscle relaxation. They are worthy to be popularized.
出处
《医学临床研究》
CAS
2011年第2期290-292,共3页
Journal of Clinical Research
关键词
剖宫产术
麻醉
cesarean section
anesthesia
