不同剂量氯普鲁卡因腰麻行剖宫产的临床观察  

Clinical observation of different doses of 2% chloroprocaine for spinal analgesia in caesarean section

作　　者：赵新民[1] 孟勇[2] 段满林[2] 邵芹[2] 曾琼[2] 张转[2] 惠康丽[1] 周志强[2] 

机构地区：[1]江苏省麻醉医学研究所,江苏徐州221002 [2]南京军区南京总医院麻醉科,江苏南京210002

出　　处：《医学研究生学报》2009年第8期837-840,共4页Journal of Medical Postgraduates

基　　金：南京军区医药卫生科研基金资助项目(批准号:06MA131)

摘　　要：目的:剖宫产等短时间的手术日益增多,氯普鲁卡因作为短效的腰麻药物一直备受麻醉医师关注;文中观察不同剂量国产氯普鲁卡因腰麻下行剖宫产对产妇的影响。方法:将120例行择期剖宫产的产妇随机分成3组,2%氯普鲁卡因28 mg(1.4 ml)组、30 mg(1.5 ml)组、32 mg(1.6 ml)组。记录产妇痛觉阻滞的最高平面,记录腰麻前和腰麻后1、3、5、7、10、15 min的平均动脉压(MAP)和心率(HR)。评价腹肌的松弛程度。结果:①痛觉阻滞最高平面均为T4,7 min均能达到最高阻滞平面。②与28 mg组相比,30 mg组和32 mg组的产妇在麻醉3、5、7min时血流动力学出现明显变化,MAP明显下降(P<0.05),伴有HR增快(P<0.05)。③术中无一例产妇诉疼痛,腹肌亦高度松弛。结论:3种剂量的氯普鲁卡因均可用于腰麻下完成剖宫产手术,但28 mg组对产妇的血流动力学影响最小。Objective： With the increasing number of short-term operations, Chloroprocaine, as a shortaction local anesthetic, has been drawing more and more attention of anesthetists. The aim of this study was to observe the effects different doses of chloroprocaine on parturient women during caesarean section under spinal analgesia. Methods： Totally 120 parturients undergoing elective caesarean section were equally randomized into 3 groups, and injected with different doses of 2% chloroprocaine into the subarachnoid space ： 28 mg （ 1.4 ml） in Group Ⅰ, 30 mg （ 1.5 ml） in Group Ⅱand 32 mg （ 1.6 ml） in Group m. The upper sensation block level was recorded, the mean arterial pressure （MAP）, heart rate （HR） , pulse oxygen saturation （SpO2） and respiration rate （RR） were monitored at 1,3, 5, 7, 10 and 15 min from the beginning of the chloroprocaine injecting into the subarachnoid space, and the relaxation of the abdominal muscles achieved in 7 min. was appraised. Results： The median maximum levels of sensory block were T4, all Compared with GroupI, Groups Ⅱ and Ⅲshowed significant hemodynamic changes, particularly a decrease of MAP （P 〈 0.05） and an increase of HR （P 〈 0.05） at 3, 5 and 7 min. None of primiparas complained of surgical pain, and their abdominal muscles were highly relaxed. Conclusion ： All the three doses of chloroprocaine can be used for spinal anesthesia in caesarean section, but the parturients are least influenced hemodynamically at 28 mg.

关 键 词：氯普鲁卡因 腰麻 剖宫产 血流动力学 

分 类 号：R971.2[医药卫生—药品]