小剂量布比卡因复合芬太尼腰-硬联合麻醉在二次剖宫产手术中的临床应用  

Clinical application of low dose bupivacaine for combined with spinal-epidural anesthesia in Repeated Cesarean Section

作　　者：唐承银 李秀满[2] 

机构地区：[1]湖南省张家界市人民医院麻醉科,湖南张家界427000 [2]贵州医科大学第三附属医院麻醉科,贵州都匀558000

出　　处：《吉林医学》2016年第9期2157-2159,共3页Jilin Medical Journal

摘　　要：目的:探讨小剂量布比卡因腰-硬联合麻醉在二次剖宫产手术中的临床效果。方法:选取二次剖宫产手术患者80例,按照随机对照表分为两组,即试验组(采用布比卡因5 mg+芬太尼20μg混合液)和对照组(采用布比卡因10 mg),每组40例,观察两组的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(Sp O2)变化、肌松效果、麻醉起效时间、最高阻滞平面到达时间、下肢运动阻滞恢复时间、不良反应(低血压、寒颤、呕吐、尿管不适)发生率以及患者满意度。结果:麻醉前两组间血流动力学差异均无统计学意义,麻醉后试验组低血压,寒颤,恶心、呕吐和尿管不适发生率均明显低于与对照组,差异有统计学意义(P<0.05);而且试验组的满意度明显高于对照组,差异有统计学意义(P<0.05);对照组较试验组最高阻滞平面到达时间短,差异有统计学意义(P<0.05);下肢运动阻滞恢复时间短于对照组,差异有统计学意义(P<0.05)。两组麻醉起效时间差异无统计学意义(P>0.05)。结论:在二次剖宫产手术中,小剂量布比卡因复合芬太尼腰-硬联合麻醉与常规剂量布比卡因相比,对血流动力学影响较小,不良反应较少,运动恢复较快,患者满意度较高。Objective To evaluate clinical efficacy of low dose bupivacaine combined with spinal epidural anesthesia （ CSEA ） in Repeated Cesarean Section. Method 80 cases of Repeated Cesarean Section were randomly divided into experimental group （bupivacaine 5 mg and fentanyl 20 μg） and control group, （bupivacaine 10 rag） ,40 cases in each group. The following were recorded and compared, hemodynamic variables （ MAP, HR, SpO2 ） , the start effect time, the arrival time of the highest block plane, the time of lower limb motor block recovery, the incidence rate of side effects and patients＇ satisfaction. Results Before anesthesia, there was no significantly differences between two groups in the hemodynamic variables （ P 〉 0. 05 ） ; After anesthesia, compared with those of control group, experimental group had fewer cases in hypotension, chill, nausea and vomiting, and discomfort of urine tube, the difference was statistically significant（P 〈 0. 05 ） ;The satisfaction degree of patients in the experimental group was significantly better than the control group,the difference was statistically significant （P 〈 0. 05） ;the arrival time of the highest block plane was shorter in experimental group （P 〈 0. 05） ;The time of lower limb motor block reovery was shorter in experimental group, the differ- ence was statistically significant than that of the control group, the difference was statistically significant （P 〈 0. 05 ） ;The start effect time no significantly differences between two groups ,the difference was not statistically significant （P 〉 0. 05 ）. Condusion In Repeated Cesarean Section, compared with conventional - does bupivacaine, low dose bupivacaine plus fentanyl combined with spinal epidural anesthesia has fewer adverse reaction, less influence on hemodynamics, earlier recovery of motion and higher satisfaction degree.

关 键 词：布比卡因 腰-硬联合麻醉 妇科 腹腔镜 

分 类 号：R614[医药卫生—麻醉学]