等效剂量罗哌卡因和布比卡因腰麻-硬膜外联合麻醉用于Misgave-Ladach-Method剖宫产术的临床研究  

Clinical investigation of the isoeffect-dose of ropivacaine and bupivacaine in combined spinal-epidural anesthesia for caesarean section of Misgave-Ladach-Method

作　　者：邵兵[1] 邹冬玲[1] 李泉[1] 刘琴湘[1] 郭训[1] 张斌[1] 

机构地区：[1]广东省清远市人民医院暨南大学医学院第五附属医院麻醉科,511500

出　　处：《中国妇产科临床杂志》2005年第3期172-174,215,共4页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的　探讨等效剂量罗哌卡因、布比卡因腰麻-硬膜外联合麻醉用于Misgave -Ladach -Method剖宫产术的临床效能及安全性。方法　选择ASAⅠ～Ⅱ级足月妊娠初产妇80例,随机双盲法分为两组,每组各4 0例。罗哌卡因组(R组) :0 75 %罗哌卡因2ml+10 %葡萄糖液0 5ml;布比卡因组(B组) :0 75 %布比卡因1 2 5ml+10 %葡萄糖液1 2 5ml。术中麻醉效应不足时经硬膜外导管补充2 %利多卡因。术中连续监测呼吸和循环状况,评估麻醉效能,观察围手术期不良反应的发生和新生儿情况。结果　两组麻醉效能、最高阻滞平面、新生儿Apgar评分及不良反应相似(P >0 0 5 ) ,但R组起效慢,维持时间短(P <0 0 5 ) ;下肢运动阻滞程度R组显著低于B组(P <0 0 5 )。结论　等效剂量的罗哌卡因和布比卡因腰麻-硬膜外联合麻醉用于剖宫产术安全有效,与布比卡因相比,罗哌卡因对下肢运动阻滞弱且恢复迅速。Objective To investigate the efficacy and safety of the isoeffect-dose of ropivacaine and bupivacaine for combined spinal-epidural anesthesia (CSEA) for caesarean section of Misgave-Ladach-Method.Methods Eighty primiparae (ASAⅠ～Ⅱ) scheduled for selective caesarean section of Misgave-Ladach-Method were divided into two groups randomly with 40 cases each.Ropivacaine group (R) received 2 ml of 0.75% ropivacaine with 0.5 ml of 10% glucose;bupivacaine group (B) received 1.25 ml of 0.75% bupivacaine with 1.25 ml of 10% glucose.It may be supplemented with 2% lidocaine via epidural catheter when the efficacy of spinal anaesthesia was poor.Blood pressure,heart rate and spo2 were assessed.Sensory and motor block,abdominal wall relaxation,Apgar score of the neonates and side effects were recorded.Results There was no significant difference among the two groups in the efficacy,the height of block,Apgar score of the neonates and side effects (P>0.05),but the onset time was later and duration of block shorter in ropivacaine group (P<0.05).Motor block was weaker with ropivacaine than that with bupivacaine (P<0.05).Conclusions The isoeffect-dose of ropivacaine and bupivacaine were effective and safe for CSEA for both parturient and neonate.The recovery from motor block is faster with ropivacaine than that with bupivacaine.Appropriate dose of ropivacaine is safe and effective.

关 键 词：腰麻-硬膜外联合麻醉 布比卡因 剖宫产术 等效剂量 临床研究 新生儿Apgar评分 10%葡萄糖液 0.75%罗哌卡因 2%利多卡因 麻醉效能 不良反应 运动阻滞 随机双盲法 硬膜外导管 新生儿情况 临床效能 方法选择 足月妊娠 麻醉效应 

分 类 号：R614[医药卫生—麻醉学]