小剂量丁卡因脊麻在剖宫产中的应用  

Small dose of tetracaine hydronhloride for the spinal anesthesia during syndrone

作　　者：宣林娜[1] 刁枢[1] 钱海良[1] 

机构地区：[1]上海市第七人民医院,上海200137

出　　处：《海南医学》2004年第12期7-8,共2页Hainan Medical Journal

摘　　要：目的对比观察剖宫产中小剂量丁卡因腰麻与连硬麻醉的效果、血压的变化;并且对比观察与阑尾腰麻的手术后并发症。方法随机取小剂量丁卡因腰麻剖宫产700例(0.08/kg-0.1/kg),丁卡因腰麻阑尾700例(0.15/kg-0.2/kg),观察阻滞的节段,平面上升的时间以及手术后出现低颅压综合症的比率。同时随机取硬膜外麻醉下的剖宫产500例与腰麻剖宫产组500例,观察其血液动力学的变化。结果用相同的速度注入药液,腰麻剖宫产组平面的上升明显快于腰麻阑尾组(p<0.05);手术后低颅压的反应明显少于腰麻阑尾(p<0.01)。腰麻剖宫产组的血压下降的时间早于连硬剖宫产组;发生率没有统计学的意义。腰麻剖宫产组的子宫的张力在取胎儿前与胎盘取出时明显低于连硬组剖宫产组,注射催产素后无差别。结论小剂量丁卡因腰麻具有作用快,松弛度好,手术后并发症少的优点,可以广泛用于剖腹产手术中。Objective To compare the small dose of tetracaine hydronhloride spinal anesthesia with epidure anesthesia during the syndrone on the differet effect, blood pressure change. To observe low cranial pressure between spinal anesthesia in the c-section with in appendectomy. Methods 700 cases using tetracaine hydronhloride in small dose for the spinal anesthesia in syndrone(0.09mg/kg-0.1mg/kg). 700 cases using tetracaine hydronhloride for the spinal anesthesia in appendectomy (0.15mg/kg-0.2mg/kg) Observe for the blocking section, the flat rising up time and the ratio of the occurrence of low cranial pressure. 500 cases of epidural anesthesia and 700 cases of spinal anesthesia for the syndrone. Observe for the changes in hemodynamics. Results in syndrone the rising up time of blocking flat is faster than what it does in appendectomy both using the same method (p<0.05); Postoperatively the occurrence of low cranial pressure is lower (p<0.01). The blood pressure goes down more quickly than using the method of epidural anesthesia; the uterus tension at the time right before the fetus is taking out and at the time when the placenta is taking out is evidently lower. Conclusion Using small doses of tetracaine hydronhloride in spinal anesthesia have the advantage of fast effect, good muscle tension, and low complication occurrence postoperatively, can be widely used in C-section.

关 键 词：腰麻 丁卡因 低颅压综合症 阻滞平面 

分 类 号：R971.2[医药卫生—药品]