布比卡因不同注药时长与剖宫产患者腰麻后仰卧位低血压的关系  

THE RELATION OF SPINAL ANESTHESIA INJECTION SPEED WITH BUPIVACAINE AND THE INCIDENCE OF SUPINE HYPOTENSIVE SYNDROME DURING CAESAREAN OPERATION

作　　者：余伶俐[1] 占乐云[1] 黄陈红[1] 刘效筠 

机构地区：[1]三峡大学人民医院麻醉科,湖北省宜昌市443000 [2]黄石市中心医院

出　　处：《中国煤炭工业医学杂志》2016年第2期198-200,共3页Chinese Journal of Coal Industry Medicine

基　　金：湖北省卫生厅重点扶持计划(编号:HW-2012BNO.037)

摘　　要：目的观察剖宫产患者行腰麻时不同注药时长对腰麻后仰卧位低血压的影响。方法择期行剖宫产术患者60例,美国麻醉医师协会（ASA）分级1~2级,采用随机数字表法分为A、B二组（每组30例）,分别以A组35~40s,B组15~20s的注药时长推注等比重0.5%布比卡因2ml进行蛛网膜下腔麻醉,观察并记录注药二组麻醉前及麻醉后1、3、5、7、10、15min时点的SBP、DBP、MAP以及HR等,记录达到T8平面所用的时间,术中恶心呕吐、静脉应用麻黄碱的例数及应用量,术后随访统计患者的术中麻醉满意度。结果 A组麻醉后各时点的SBP、DBP、MAP以及HR等指标无明显下降趋势,A组3、5、7min时点的SBP、DBP、MAP及HR与B组比较差异有统计学意义,达T8平面时间A组显著长于B组,A组术中发生恶心、呕吐的例数及追加麻黄素的例数和用量显著少于B组,术中麻醉满意度高于B组。结论剖宫产患者行腰麻时,以较慢的注药速度（推药时间35~40s）推注等比重0.5%布比卡因,可以减少腰麻后仰卧位低血压的发生率。Objective To research the influence to the incidence of supine hypotensive syndrome during caesarean operation spinal anesthesia with the different speed of Bupivacaine to subarachnoid space.Methods Totally 60 cases of optional cesarean section maternal（ASA I-II）,weight 53-86 kg,height 150-170 cm,age 19-38 years old.All patients were randomly assigned into two groups（group A,B）,each group with30 cases.The group A was injected within35-40 s with0.5% bupivacaine,while the group B received injected within 15-20 s with0.5% Bupivacaine.The puncture point was between two and three lumbar,and the total volume was 2 ml.The hemodynamic changes of all cases were observed,and the SBP,MAP,DBP,HR were recorded before anesthesia（T0）,1 min after anesthesia（T1）,3 min（T3）,5 min（T5）,7min（T7）,10 min（T10）,15 min（T15）.The time of reaching the T8 plane,intraoperative nausea and vomiting,the use and times of Ephedrine dosage,and the satisfaction rate of anaesthetic effect were recorded,respectively.Results The influence on hemodynamics in group A was bigger than group B（P〈0.05）,but there was no significant difference in SBP,DBP,MAP and HR at 3,5,7 min in group A before and after anesthesia.The time of reaching the T8 plane in group A was longer than that in group B,but there was no influence to the operation.The dosage of Ephedrine in group B was higher than group A.Conclusion A lower spinal anesthesia injection speed（35-40s）can reduce the incidence of supine hypotensive syndrome during caesarean operation.

关 键 词：剖宫产 腰麻 仰卧位低血压 注药时长 

分 类 号：R614.26[医药卫生—麻醉学]