不同比重布比卡因腰麻液用于剖宫产手术的比较.doc

不同比重布比卡因腰麻液用于剖宫产手术的比较 【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(p0．05)。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); conclusion 0.5% isobaric bupivacaine for combined spinal-epidural anesthesia on cesarean section were more stable and more safer for mother and child. 【key words】cesarean section spinal anesthesia bupivacaine isobaric weigh proportion 近年来腰麻-硬膜外联合麻醉（csea）已广泛应用于剖宫产术中，临床常用的腰麻液为布比卡因，但是所用的浓度及比重差异很大，效果也有所不同。本研究比较等比重与重比重布比卡因腰麻液在剖宫产手术中的应用效果及对母婴的影响，探讨比较合理的布比卡因腰麻液比重，为临床提供参考。 1 资料与方法 1.1 一般资料 选择asai一ⅱ级行剖宫产术的单胎初产妇200例，术前检查未见妊娠合并症。随机分为等比重组（a组）和重比重组（b组），每组100例。两组产妇的年龄、体重及身