布比卡因+芬太尼等比重液在剖宫产术中的应用  

The Application of Subarachnoid Block with Bupivacaine Fentanal in Cesarean Section

作　　者：王娟[1] 

机构地区：[1]安徽省淮北市矿工总医院麻醉科,235000

出　　处：《中华全科医学》2011年第3期362-363,共2页Chinese Journal of General Practice

摘　　要：目的探讨布比卡因+芬太尼等比重液蛛网膜下腔阻滞在剖宫产术中的安全性和可行性。方法选择剖宫产患者97例,美国麻醉师协会分级(ASA)Ⅰ或Ⅱ级,年龄16～32岁,身高156～175 cm,体重65～90 kg,随机分为布比卡因+芬太尼等比重液组(A组n=48)和布比卡因重比重液组(B组n=49)。结果两组各有1例因穿刺失败或不能回抽出脑脊液而被剔除本研究,两组年龄、体重、身高和ASA分级比较差异无统计学意义(P>0.05),两组感觉阻滞平面范围T6～10与B组相比,A组阻滞完善时间感觉阻滞维持时间明显延长(P<0.01),麻醉质量差异无统计学意义(P>0.05),见表1。与B组相比,A组低血压发生率降低,皮肤瘙痒发生率升高(P<0.01),心动过缓,呼吸抑制,寒颤及新生儿Apgar评分差异无统计学意义(P>0.05)。结论布比卡因+芬太尼等比重液蛛网膜下腔阻滞在剖宫产术中是安全和可行的。Objective To investigate the safety and feasibility of subarachnoid block with the same specific gravity liquid of bupivacaine plus fentanyl in cesarean section. Methods 97 cesarean section patients, according to American association of the anesthesiologist classification （ASA） I or II level, aged 16 - 32 years, height 156 - 175 cm, weight, 65 - 90 kg, were randomly divided into same specific gravity bupivacaine plus fentanyl group （ group A, n = 48 ） and heavier specific gravity bupivacaine group（group B,n = 49）. Results There was one patient in each group eliminated from the study for puncture failure or suction of no CSF. There was no significant difference in the patients＇ age,weight, height and ASA classification between the two groups. In the two groups,the block of feeling range was T6-1o. The block time of A group was longer than that of group B（ P 〈 0.01 ）. There was no difference in the quality of anesthesia between the two groups. Compared with the group B ,the incidence of hypoten- sion decreased（P 〈0. O1 ） and itchy skin of A group increased obviously（ P 〈 O. 01 ）. And there was no difference in the incidence of bradycardia, respiratory inhibition, shivering and neonatal Apgar score between the two groups （ P 〉 0. 05 ）. Conclusion The application of subarachnoid block with the same specific gravity liquid of bupivacaine plus fentanyl in cesarean section was safe and feasible.

关 键 词：布比卡因+芬太尼 等比重液 剖宫产 

分 类 号：R614.4[医药卫生—麻醉学] R719.8[医药卫生—外科学]