罗哌卡因等比重液用于剖腹产病人腰-硬联合阻滞的临床观察  

Application of Isobaric Ropivacaine in Combined Spinal-epidural Anesthesia for Caesarean

作　　者：马骠 

机构地区：[1]江苏省淮安市楚州医院,223200

出　　处：《青海医药杂志》2011年第9期8-10,共3页Qinghai Medical Journal

摘　　要：目的:罗哌卡因等比重液用于剖腹产腰-硬联合阻滞的安全性和有效性。方法:择期行剖腹产病人90例,ASA(Ⅰ～Ⅱ)级,随机分成3组,每组30例。用DurasafeTM型联合阻滞配套针于L2～3间隙穿刺。以0.1mL/s的速率蛛网膜下隙注入等比重混和局麻药3mL(B组:布比卡因7.5mg;R1组:罗哌卡因7.5mg;R2组:罗哌卡因10mg),术中酌情于硬膜外给予2%利多卡因维持麻醉。用针刺法测感觉阻滞平面,用改良Bromage法测运动阻滞程度。比较三组病人在感觉、运动阻滞及恢复方面的异同,记录麻醉各时点血压、心率变化,并观察用药后的不良反应。结果:三组均能提供较为完善的麻醉。R组的运动阻滞起效时间长于B组(P<0.01),运动阻滞恢复时间短于B组(P<0.01)。R1组感觉阻滞消退到S1～2时间、完全运动阻滞发生率明显少于B组(P<0.01)。结论:罗哌卡因等比重7.5mg腰-硬联合阻滞用于剖腹产病人是安全的,其循环和呼吸系统较稳定,未见严重并发症,并能达到较为完善的麻醉效果。Objective：To determine the clinical efficacy and safety of ropivacaine in combined spinal-epidural anesthesia（CSEA） for caesarean.Methods：Ninety women who were identified with ASA（I^II） were divided into randomLy three groups of 30 each;group B,R1 and R2 received 0.25% bupivacaine 7.5mg,0.25% ropivacaine 7.5mg and 0.33% ropivacaine 10mg respectively through L2~3space puncture,and the epidural anesthesia was maintained with 2% lidocaine if necessary during the operation.The level and duration of sensory anesthesia were recorded bilaterally by a pinprick test,and motor block in limb was assessed with a modified Bromage scale.Hemodynamic changes and side effects were observed after spinal anesthesia.Results： Three groups had perfect quality of anesthesia.As compared with group B,group R produced longer time to maximum motor block（P0.01） and shorter time to motor recession（P0.01）;more than,group R1 expressed shorter time（S1~2） of sensory block and less motor lockage（P0.01）.Conclusions：Application of 7.5mg rolivacaine is safe and effective;the circulating and respiratory system are stable and less complication in CSEA for caesarean.

关 键 词：罗哌卡因 布比卡因 等比重液 腰-硬联合阻滞 剖腹产病人 

分 类 号：R614.42[医药卫生—麻醉学] R719.8[医药卫生—外科学]