两种不同比重布比卡因腰麻在高龄产妇剖宫产手术中的应用效果比较  

Application effect comparison of two different proportions of bupivacaine on lumbar anesthesia in cesarean section surgery of elderly delivery women

作　　者：李文英[1] 曾垂应[1] 

机构地区：[1]福建省龙岩市第二医院麻醉科,龙岩364000

出　　处：《福建医药杂志》2018年第1期35-38,共4页Fujian Medical Journal

摘　　要：目的比较两种不同比重布比卡因腰麻在高龄产妇剖宫产手术中的应用效果。方法回顾性分析我院2015年9月至2016年11月收治的280例高龄剖宫产手术产妇的临床资料,将采用重比重布比卡因腰麻的118产妇列为对照组,轻比重布比卡因腰麻的162例产妇列为观察组。对比两组产妇麻醉阻滞起效时间、最高阻滞平面、最高阻滞平面起效时间、麻醉恢复时间、视觉模拟评分(VAS);同时观察注射药物后2min、5min的收缩压、舒张压、心率等血流动力学的变化情况,并统计低血压、恶心呕吐、产后出血等不良事件发生率及麻黄碱使用率。结果观察组麻醉阻滞起效时间、最高阻滞平面起效时间较对照组长,麻醉恢复时间较对照组短,且低血压、产后出血发生率及麻黄碱使用率均较对照组低,以上对比差异均有统计学意义(P<0.05);但观察组产妇各时点血流动力学较对照组平稳,收缩压、舒张压及心率波动幅度均小于对照组;且两组患者最高阻滞平面及VSA评分对比差异均无统计学意义(P>0.05)。结论轻比重布比卡因能避免产妇血流动力学大幅度波动,减少低血压及产后出血的发生率及术中麻黄碱的使用,生命体征平稳,安全性更佳。Objective To compare the application effects of two different proportions of bupivacaine on lumbar spinal an- esthesia in the cesarean section surgery of elderly delivery women. Methods The clinical data of 280 cases of elderly delivery women with cesarean section in our hospital from September 2015 to November 2016 were analyzed retrospectively. A total of 118 cases of puerpera treated with high proportion of bupivacaine on lumbar anesthesia were enrolled in the control group, and 162 cases of puerpera treated with light proportion of bupivacaine on lumbar anesthesia were selected as the observation group. The onset time, highest block plane, highest block onset time, anesthesia recovery time and visual analogue scale （VAS） were compared between the two groups. At the same time, the changes of systolic blood pressure, diastolic blood pressure, heart rate and other hemodynamics were observed at 2 min and 5 min after injection, and the incidence rates of hypotension, nausea and vomiting, postpartum hemorrhage and other adverse events and the utilization rate of ephedrine were counted. Results The on- set times of the anesthesia block and the highest block plane were higher in the observation group than those in the control group, and the recovery time of the anesthesia was shorter than that in the control group （P〈0. 05）, and the incidence rates of hypotension and postpartum hemorrhage and the utilization rate of ephedrine were lower than those in the control group （all P 〈 0.05）. The hemodynamic levels at each time point in the observation group were significantly more stable than those in the con- trol group, and the amplitude changes of the systolic blood pressure, diastolic blood pressure and heart rate were significantly lower than those in the control group. At the same time, there was no significant difference in the highest block level and VSA score between the two groups （P 〉0.05）. Conclusion The light proportion of bupivacaine can avoid maternal hemodynamic fluctuations and reduce t

关 键 词：不同比重 布比卡因 腰麻 高龄妊娠 剖宫产手术 

分 类 号：R719.8[医药卫生—妇产科学]