3种不同比重布比卡因用于剖宫产麻醉的临床效果观察  

Observation the efficacy of three different specific gravity bupivacaine for spinal anaesthesia in cesarean section

作　　者：赵佳佳 李晓强 潘丽峰 张科学 Zhao Jiajia;Li Xiaoqiang;Pan Lifeng;Zhang Kexue(Department of Pediatric Surgery,The Hospital of Shunyi District Beijing,Beijing,101300,China;Department of Endocrinology,the First Medical Center,Chinese PLA General Hospital,Beijing,100853,China)

机构地区：[1]北京顺义区医院麻醉科,北京101300 [2]中国人民解放军总医院第一医学中心小儿外科,北京100853

出　　处：《当代医学》2020年第11期26-28,共3页Contemporary Medicine

摘　　要：目的比较3种不同比重布比卡因用于剖宫产的麻醉效果。方法选取2018年1月至2019年7月本院择期行剖宫产手术的产妇90例,随机分为A、B、C 3组,每组30例。分别采用注射用灭菌用水、脑脊液、10%葡萄糖配置成轻、等、重比重布比卡因腰麻液行腰麻操作。观察记录各组患者麻醉效果及其不良反应情况。结果B组患者切皮时发生感觉消退平面过低(<T6)或过高(>T4)明显少于A组、C组(P<0.05);A组术中硬膜外追加用药与B组、C组比较明显增加(P<0.05);C组在给药后2 h患者Bromage分级为Ⅰ级患者显著少于A组、B组,Bromage分级为Ⅲ级的患者显著多于A组、B组,Bromage分级为Ⅳ级的患者显著多于A组(P<0.05);C组发生低血压、窦缓、恶心/呕吐、胸闷/气短例数显著高于A组、B组(P<0.05)。结论等比重布比卡因用于剖宫产麻醉麻醉效果较好,不良反应发生率低,产妇恢复快,值得临床推广应用。Objective To compare the anesthetic effect of three different specific gravity bupivacaine in cesarean section.Methods From January 2018 to July 2019,a total of 90 parturients who underwent elective cesarean section in our hospital were randomly divided into group A,group B and group C,with 30 cases in each group.sterilizing water,cerebrospinal fluid and 10%glucose were used to prepare hypobaric,isobaric and hyperbaric bupivacaine for lumbar anesthesia.Anesthesia effect and adverse reactions were observed and recorded in each group.Results Fewer patients in group B had blocks that were either too low(<T6)or too(>T4)(P<0.05).More patients need epidural supplement in group A than group B and C(P<0.05).2 h after administration,the Bromage scale in gradeⅠin group C were significantly less than in group A and group B,more patients than group A and group B in gradeⅢ,and more patients than group A in gradeⅣ(P<0.05).The incidence of hypotension,bradycardia,nausea or vomiting,chest distress or pant in group C was significantly more than that in group A and group B(P<0.05).Conclusion Isobaric bupivacaine has a good anesthetic effect on cesarean section,low incidence of adverse reactions and rapid recovery,which is more worthy of clinical promotion.

关 键 词：布比卡因 腰麻 剖宫产 麻醉 

分 类 号：R719.8[医药卫生—妇产科学] R614[医药卫生—临床医学]