剖宫产产妇硬膜外腔注药后压力与扩散速度及用药量的关系.pdfVIP

临床麻醉学杂志 2008年 1O月第 24卷第 1O期 JClinAnesthesiol，October2008，Vo1．24，No．10 ． 临 床 研 究 ． 剖宫产产妇硬膜外腔注药后压力与扩散速度及 用药量的关系 张青林 徐铭军 【摘要】 目的 探讨择期剖宫产产妇硬膜外腔注药后 的硬膜外腔压力、扩散及用药量特征。方 法 择期剖宫产手术 (0组)和择期开腹妇科手术 (G组)患者各 3O例 ，均于 L 间隙硬膜外腔穿刺 置管。每隔5分钟硬膜外腔以0．5ml／s速度泵注0．75 罗哌卡因5ml，共 3次。观测并记录两组每 次注射后 1、3、5min的硬膜外腔压力 (EP)，测量末次给药 15min后阻滞平面，计算脊髓节段阻滞用 药量(sV)。结果 两组硬膜外腔注药后各时点的压力和扩散速度差异无统计学意义 。0组 SV为 (1．27士0．05)ml，明显少于 G组的 (1．46±0．04)ml(P0．05)(减少 了 l1．8 )。结论 择期剖宫 产产妇注药后 EP和局麻药扩散速度与非孕妇相仿。达到相同的阻滞平面，剖宫产硬膜外用药量可 比非孕妇减少 】1．8 。 【关键词】 剖宫产术；硬膜外阻滞 Characeristicsofepiduralpressure，spread and dosageoflocalanestheticsduring epiduralblock for pregnantwomenundergoingselectivecesareansection ZHANG Qing-lin，XUMing-jun．Department ofAnesthesiology，AffiliatedBeijingObstetricsandGynecologyHospital，CapitalMedicalUniversity， Beijing100026，China [Abstract] 0bjective Tostudythecharaceristicsofepiduralpressure，spreadanddosageof localanestheticsduring epiduralblock forpregnantwomen undergoing selective cesarean section． Methods Thirtypregnantwomen undergoingselectivecesarean section (group ())andthirtynon— pregnantwomenundergoinggynecologicalsurgery (groupG)weregivenepidura1block．Fivemlof 0．75 ropivacainewaspumpedinarateof0．5ml／satfirsttimeandinjectedtwiceinanintervalof5 minintotheepiduralspaceviaepiduralcatheter．Theepiduralpressure (EP)wasmeasuredat1，3， and5min aftertheinfusion．Anestheticplanewaschecked and 1ocalanesthiticamountperspina1 segment(SV)wascalculatedat15minafterthefinalinjection．Results Therewerenosignificant differencesinEP andspreadspeedbetweenthetwogroups．TheSV ofgroupO was(1．27±0．05) ml，whichwassignificantlylessthan (1．46±0．04)mtingroupG (P-0．05)．Conclusion TheEP andanetheticspreadofpregnantwomenundergoingselectivecesareansectionunderepiduralblockare similartothoseofnonpregnantwomen，butthelocalanesthiticamountperspinalsegmentisreduced about11．8 ． [Keywords] Cesareanse