等比重布比卡因在剖宫产腰硬联合麻醉中阻滞平面与体位关系  

Study on the relationship between the block Level and the body position in the same proportion bupivacaine used for combined spinal and epidural anesthesia during caesarean section

作　　者：姜琰[1] 王婕 迟琨[1] JIANG Yan;WANG Jie;CHI Kun(Qingdao Municipal Hospital,Shandong Province,266011 Abstr)

机构地区：[1]青岛市市立医院

出　　处：《中国计划生育学杂志》2019年第11期1456-1459,共4页Chinese Journal of Family Planning

摘　　要：目的:研究等比重布比卡因在剖宫产腰硬联合麻醉中的阻滞平面与体位关系。方法:2016年1月-2019年1月本院妇产科剖宫产75例产妇,采用随机数字法分组,I组采取水平卧位,II组采取头低足高角度为5°卧位,III组采取角度为10°头低足高卧位,剖宫产术中均采用等比重布比卡因的腰硬联合麻醉,把L3~L4椎间隙作为穿刺点,将等比重布比卡因(0.75%)注射进蛛网膜下腔,观察产妇麻醉效果,注药后孕妇的感觉阻滞的相对平面和绝对平面,注药前后孕妇的收缩压,心率和心输出量及给药后不良反应和血管活性药物使用情况。结果:III组麻醉阻滞的绝对平面(T 7±1.21)和相对平面(T 5±1.38)均高于II组(T8±1.56、T 6±1.35)和I组(T 8±1.32、T 6±1.04)(P<0.05);3组麻醉前和麻醉后血流动力各项指标比较,不良反应和血管活性药物应用情况比较均无差异(均P>0.05)。结论:在头低足高10°体位下,使用等比重布比卡行腰硬联合麻醉阻滞麻醉效果更佳,对血流动力学无明显影响,且无不良反应增加。Objective:The study of the relationship between the block Level and the body position in the same proportion isobaric bupivacaine used for combined spinal and epidural anesthesia during caesarean section.Methods:From January 2016 to January 2019,75 women who wanted caesarean section were selected and divided into 3 groups(25 cases in each group).During caesarean section,all women had accepted the intervertebral space of L3 L4 was inserted into the subarachnoid cavity and the same proportion of bupivacaine(0.5%)was injected into the subarachnoid cavity.And women in group I adopted the supine position,women in group II adopted the trendelenburg position with 5°,and women in group III adopted the trendelenburg position with 10°.The effect of anesthesia,the relative and absolute plane of the sensory block after injection,the systolic blood pressure,heart rate,and cardiac output before and after the injection,and the adverse reactions such as nausea and vomiting,and vasoactive drug used of pregnant women in the three groups were observed.Results:The absolute plane and the relative plane of anesthesia block of women in group III were T7±1.21 and T5±1.38,which were significant higher than those(T8±1.56 and T6±1.35,T8±1.32 and T6±1.04)of women in group I and II(P<0.05).There were no significant difference in index of hemodynamics before and after the anesthesia,adverse reactions rate,and the dosage of vasoactive drugs used of women among the three groups(P>0.05).Conclusion:When women adopt the trendelenburg position with 10°during cesarean section,the same proportion isobaric bupivacaine used for combined spinal and epidural anesthesia has the best anesthesia effect,which has no adverse influence on hemodynamics and adverse reactions of women.

关 键 词：剖宫产术 腰硬联合麻醉 等比重 布比卡因 体位 

分 类 号：R[医药卫生]