等效剂量罗哌卡因、布比卡因腰麻-硬膜外联合麻醉在剖宫产术中的应用  

Application of the isoeffect-dose of ropivacaine and bupivacaine for combined spinal-epidural anesthesia(CSEA) for Misgave-Ladach-Method of caesarean section

作　　者：陈石卿[1] 

机构地区：[1]湖面省湘南学院附属医院麻醉科,湖南郴州423000

出　　处：《中国民族民间医药》2009年第24期100-101,共2页Chinese Journal of Ethnomedicine and Ethnopharmacy

摘　　要：目的：探讨等效剂量罗哌卡因、布比卡因腰麻-硬膜外联合麻醉在剖宫产术中的应用。方法：选择ASAⅠ～Ⅱ级足月妊娠初产妇60例，随机双盲法分为两组，每组各30例。罗哌卡因组（R组）：0．75％罗哌卡因2ml回吸脑脊液至2．5ml；布比卡因组（B组）：0．75％布比卡因2ml用脑脊液稀释到3ml，注药2ml（布比卡因10mg）。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〉0．05），但R组感觉阻滞起效慢，维持时间短（P〈0．05）；下肢运动阻滞程度R组鼹著低于L组（P〈0．05或P〈0．01）。结论：等效剂量的岁哌卡因和布比卡凶腰麻一硬膜外联合麻醉用于剖宫产术安全有效，与布比卡凶相比，岁哌卡因对下肢运动阻滞弱目．恢复迅速。Objective To explore the efficacy and safety of the isoeffect - dose of ropivacaine and bupivacaine for combined spinal - epidural anesthesia （CSEA） for Misgave - Ladach - Method of caesarean section. Methods Sixty primiparae （ ASA Ⅰ-Ⅱ） schedualed for elective Misgave - Ladach - Method of caesarean section were divided into two groups with 30 cases each. Ropivacaine group （R） received 2ml of 0. 75% ropivacaine with 0. 5ml of with cerebrospinal fluid： bupivacaine group （B） received 2ml of 0. 75% bupivacaine with 1 ml of cerebrospinal fluid. 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 longer and duration of block shorter in ropivacaine group （ p 〈 0. 05 ）. Motor block was weaker with ropivacaine than that with bupivacaine （ p 〈 0. 05 or p 〈 0. 01 ）. Conclusion 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：罗哌卡因 布比卡因 腰麻-硬膜外联合麻醉 剖宫产 

分 类 号：R719.82[医药卫生—妇产科学]