等比重左旋布比卡因和重比重布比卡因腰硬联合麻醉用于剖宫产手术的效果比较  

A comparison of combined spinal-epidural anesthesia with isobaric levobupivacaine and hyperbaric bupivacaine for cesarean sections

作　　者：李军[1] 魏志英 段思源[1] 刘晶 

机构地区：[1]上海中医药大学附属上海市中西医结合医院,上海200082 [2]上海市杨浦区控江医院,上海200093

出　　处：《现代中西医结合杂志》2015年第13期1381-1383,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：上海市虹口区卫计委资助课题(虹卫1403-01)

摘　　要：目的 评估0.5%等比重左旋布比卡因10mg与0.5%重比重布比卡因10mg腰硬联合麻醉用于剖宫产的临床效果。方法 将60例ASAⅠ~Ⅱ级择期剖宫产的产妇随机分为2组,每组30例。LF组用0.5%等比重左旋布比卡因10mg进行腰硬联合麻醉;BF组用0.5%重比重布比卡因10mg腰硬联合麻醉。用针刺皮肤法和改良运动阻滞（Bromage）分级法评估2组感觉和运动阻滞情况,观察并记录2组血流动力学变化和不良反应发生情况。结果LF组达到最大感觉阻滞时间、感觉阻滞消退时间以及感觉阻滞消退平面达T12的时间均短于BF组,BF组运动阻滞发展得更快,持续时间更长;LF组低血压、心动过缓、恶心的发生率低于BF组（P均〈0.05）。结论 0.5%等比重左旋布比卡因10mg腰硬联合麻醉用于剖宫产产生的运动阻滞时间更短,低血压、心动过缓、恶心的不良反应发生率更低,是剖宫产腰硬联合麻醉一个更好的替代方法。Objective It is to investigation the efficacy and safety of combined spinal - epidural anesthesia（CSEA） with i- sobaric levobupivacaine and hyperbaric bupivacaine for cesarean sections. Methods Sixty primiparaes （ASA Ⅰ Ⅱ ） sched- ualed for elective caesarean section were divided into two groups with 30 cases each. Isobaric levobupivacaine group（LFgroup） received 0.5% isobaric levobupivacaine 0Omg; Hyperbaric bupivacaine group（BFgroup） received 0.5% hyperbaric bupiva- caine10mg. Sensory and motor block characteristics of the groups were assessed with pinprick and Bromage scale; Hemody- namic changes and side effects were observed and recorded in both groups. Results The time to reach maximum dermatome for the sensory block, time to regression and time to regress to T12 dermatome was found to be significantly long in Group BF. It was observed that in Group BF, the evolution of the motor block was faster and lasted longer. Whereas hypotension, bradycar- dia and nausea were less in Group LF（P 〈 0.05）. Conclusion Since motor block time is shorter, and side effects like hypo- tension, bradycardia and nausea are less,levobupivacaine for combined spinal-epidural anesthesia can be a good alternative in cesarean sections.

关 键 词：左旋布比卡因 布比卡因 腰-硬联合麻醉 等比重 重比重 剖宫产 

分 类 号：R971.2[医药卫生—药品]