产妇腰硬联合麻醉硬膜外追加利多卡因和生理盐水对麻醉平面的影响  

Combined spinal and epidural anesthesia for cesarean section:comparison of the effect on sensory level by epidural injection of lidocaine and saline solution

作　　者：王春林 黄唯 何虹 

机构地区：[1]上海市长宁区妇幼保健院麻醉科,200051

出　　处：《中华临床医师杂志（电子版）》2013年第3期89-91,共3页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的比较产妇腰硬联合麻醉时硬膜外腔追加生理盐水和利多卡因对腰麻无痛觉平面的影响。方法 90例ASAⅠ～Ⅱ择期剖宫产患者,随机分为三组:空白组、利多卡因组和生理盐水组。蛛网膜下腔注药10min后,生理盐水组和利多卡因组分别向硬膜外腔注入生理盐水8ml、1.73%碳酸利多卡因8ml,而空白组则不加药。观察记录自硬膜外注药后不同时间节点的麻醉无痛觉平面,监测用药后20min内的血压变化,并观察T10感觉阻滞恢复时间和运动恢复时间(Bromage为3)。结果生理盐水和利多卡因组麻醉无痛觉平面上升幅度与空白组对比差异均有统计学意义(P<0.01),利多卡因组血压下降>20%需要作升压处理的概率较高,三组间的感觉阻滞维持时间和运动恢复时间比较无统计学差异(P>0.05)。结论剖宫产实施腰硬联合麻醉中,硬膜外腔追加生理盐水或利多卡因均能有效扩展无痛觉麻醉平面,而追加生理盐水更为安全。Objective To compare the effect on sensory level by epidural injection of saline solution and lidocaine during combined spinal and epidural anesthesia for cesarean section.Methods 90 cases of parturients with ASA Ⅰ-Ⅱ who underwent elective cesarean section were randomly assigned into three groups （n =30 parturients/group）：control group,lidocaine group and saline solution group.Ten min after subarachnoid injection,8 ml of saline solution was injected into the epidural space in saline solution group and 8 ml of 1.73％ lidocaine was in lidocaine group whereas no drug was in control group.Sensory level was respectively tested at different times after epidural injection.Blood pressure was recorded within 20 min after epidural injection.The duration of sensory and motor block were observed.Results The increase of sensory level in saline solution group and lidocaine group were more significant than that in control group（P ＜ 0.01）.The incidence of hypotension in lidocaine group was statistically higher than those in other two groups.There was no significant difference between the duration of sensory and motor block among the three groups.Conclusions During combined spinal and epidural anesthesia for cesarean section,sensory level can be significantly elevated by epidural injection of either saline solution or lidocaine,injection of saline solution is safer.

关 键 词：剖宫产术 麻醉 利多卡因 

分 类 号：R614[医药卫生—麻醉学]