摘要
目的 :观察两种浓度布比卡因等比重液腰麻的效果。方法 :选择下腹部、会阴部及下肢手术患者 4 0 1 8例 ,5～ 82岁 ,ASAI～Ⅱ级。采用 7号腰穿针于L2～ 5 椎间隙穿刺 ,以 0 .1ml·s- 1的速度蛛网膜下腔注入 0 .5% (I组 )或 0 .75% (Ⅱ组 )布比卡因 1～ 3ml,用针刺法测得阻滞平面并监测ECG、MAP、HR、RR和SpO2 变化。所有病例麻醉前或同时输入乳酸林格氏液 50 0～ 1 0 0 0ml或羟乙基淀粉氯化钠 50 0ml。结果 :两种溶液的起效与持续时间、阻滞平面差异无显著性 ,麻醉成功率为 99.1 %～ 99.3 %。其中Ⅱ组布比卡因平均用量 ( 1 .98± 0 .1 2 )ml少于Ⅰ组 ( 2 .2 3± 0 .3 0 )ml,差异具有显著性意义 (P <0 .0 5) ,与阻滞前比较 ,注药后3 0min两组MAP下降均较明显 (P <0 .0 5) ,部分病例术中使用了升压药物。结论 :0 .5%或 0 .75%布比卡因等比重液用于腰麻是安全的 ,操作方法简便、用药单一、起效迅速、作用时间长、麻醉效果完善、麻醉平面易于控制。
Objective:To investigate the efficacy of isobaric bupivacaine in spinal anesthesia of different concentration.Methods:The lower abdominal perineum and lower limb surgery were chosen in 4 018 patients,ASA class Ⅰ-Ⅱ,5 to 82 years old.During puncture was performed at L 2～5 interspace in the lateral position,patients were received 0.5%(group Ⅰ)or 0.75%(group Ⅱ)isobaric bupivacaine respectively,the total volume was 1～3 ml,the level of sensory anestheia was determined by pinprick.ECG,MAP,HR,RR and SpO 2 were monitored during operation. Results:The average upper level of sensory block(T 2～4 )was the same in both groups,the average dose of drugs in group Ⅱ was (1.98±0.12) ml less than group Ⅰ(2.23±0.30 ml),the difference was significant( P <0.05).After injecting local anesthetic in subarachnoid 30 min,MAP decreased significantly compared with base value( P <0.05).There were no significant differences between groups for efficacy of spinal anesthesia and complication.Conclusion:0.5% or 0.75%isobaric bupivacaine is safe and effective for spinal anestheia.
出处
《西北国防医学杂志》
CAS
2001年第3期248-250,共3页
Medical Journal of National Defending Forces in Northwest China
关键词
麻醉学
布比卡因
腰麻
等比重液
Anesthesiology
Bupivacaine
Spinal anesthesin
Isobaric solution
