左布比卡因与布比卡因腰麻在剖宫产术中麻醉效果评价  

Comparison of the effects of the different doses of levobupivacaine and bupivacaine for spinal anesthesia in patients undergoing caesarean section

作　　者：秦学斌[1] 廖芝玲[2] 林高翔[1] 张文斌[1] 赵振海[1] 李敏[1] 

机构地区：[1]桂林医学院附属医院麻醉科,广西桂林541001 [2]广西医科大学病例生理学教研室,广西南宁530021

出　　处：《中国医院药学杂志》2013年第7期556-558,共3页Chinese Journal of Hospital Pharmacy

摘　　要：目的:研究左布比卡因与布比卡因腰麻在剖宫产术中麻醉效果。方法:选择ASAⅠ～Ⅱ级剖宫术产妇180例,年龄23～36岁,体质量55～90kg,身高150～175cm,随机、双盲分成6组,每组30例,均采用腰硬联合麻醉,L2-3椎间隙穿刺,穿刺成功后蛛网膜下腔分别注入0.75%左布比卡因(加10%葡萄糖至2mL)于A1组(7.5mg)、B1组(10mg)、C1组(12.5mg),0.75%布比卡因(加10%葡萄糖至2mL)于A2组(7.5mg)、B2组(10mg)、C2组(12.5mg),注药时间均为1mL/5s。给药后用针刺法测定感觉阻滞平面,给药15min后阻滞平面未达T6水平者经硬膜外分次酌情追加2%利多卡因。麻醉期连续监测BP、HR、ECG和SPO2,观察并记录给药后15min麻醉平面、麻醉效果、并发症的发生率及新生儿1min和5min分钟的Apgar评分。结果:在并发症的发生率及新生儿1min和5min的Apgar评分等方面,6组间无明显差异(P>0.05);在麻醉效果方面,A1组与A2组比较有显著意义(P<0.05),在麻醉平面及麻黄素使用剂量中,C2组与C1组比较,有明显差异(P<0.05)。结论:0.75%左布比卡因(10mg和12.5mg)腰麻在剖宫产术中麻醉效果是有效的且安全的。0.75%(10mg)布比卡因腰麻在剖宫产术中也是比较适合的剂量。OBJECTIVE To compare the effects of the different doses of levobupivacaine and bupivacaine for spinal anesthesia in patients undergoing caesarean section. METHODS 180 patients ASA Ⅰ or Ⅱ, 23 to 36 years old,weighing 55 to 90 kg,height 150 to 175 cm were randomly divided into six groups（n = 30 each） and allocated to receive spinally hyperbaric mixture 2 ml at 1 mL/5 s were combined with 10 % glucose and 0. 75% levohupivacaine （group A1 7. 5 mg,group B1 10 mg,group C1 12. 5 mg） or 0. 75% bupivacaine （group A2 7. 5 mg,group B2 10 mg group C2 12. 5 mg） respectively, and the anesthesia was maintained with epidural administration with 2 % lidocaine if necessary during the operation , after combined spinal epidural anesthesia was applied at the L2-3 interspace. Continuous monitoring BP, HR, ECG and SPO2, anesthesia levels, anesthesia effect, complications of anesthesia, and Apgar score of the neonates were observed. RESULTS Complications of anesthesia, Apgar score of the neonates were similar in six group（P〉0. 05）. Anesthetic effect was significant difference in group A1 than group A2 were significant （P〈0. 05）, anesthesia levels and ephedrine dose in group C1 than group C2 were significant（P〈0. 05）.CONCLUSION 0. 75% Levobupivacaine（10 mg and 12. 5 mg） and 0. 75% bupivacaine（10 mg） are effective and safe for spinal anesthesia in patients undergoing caesarean section.

关 键 词：左布比卡因 布比卡因 腰麻 剖宫产术 

分 类 号：R969[医药卫生—药理学]