不同比重布比卡因在急诊剖宫产术中的肌肉松弛效果比较  

Comparison of different specific gravity bupivacaine on muscle relaxation during emergency cesarean section

作　　者：刘刚 陈应书 邹春艳 谭禄伦 廖敏 熊涛 LIU Gang;CHEN Yingshu;ZOU Chunyan;TAN Lulun;LIAO min;XIONG Tao(Department of Anesthesiology,Qijiang District Hospital of Traditional Chinese Medicine,Chongqing 401420,China)

机构地区：[1]重庆市綦江区中医院麻醉科,重庆401420

出　　处：《检验医学与临床》2022年第12期1621-1624,共4页Laboratory Medicine and Clinic

基　　金：重庆市綦江区科技攻关类项目(2020067)。

摘　　要：目的比较两种麻醉方案在急诊剖宫产术中的肌肉松弛效果。方法将80例行急诊剖宫产术的产妇随机分成观察组和对照组,每组各40例。观察组产妇给予0.5%布比卡因注射液混合自身脑脊液稀释麻醉,对照组产妇给予0.5%布比卡因注射液混合10%葡萄糖注射液稀释麻醉。比较两组术中取胎儿及关腹缝合腹膜时肌肉松弛效果、手术肌肉松弛满意度、麻醉效果,产妇麻醉前、蛛网膜下腔注药后5、10、15、30 min的收缩压(SBP)、舒张压(DBP)和心率(HR),术后随访产妇对麻醉的整体满意度。结果两组术中取胎儿及关腹缝合腹膜时肌肉松弛效果比较,差异无统计学意义(P>0.05),观察组术中肌肉松弛满意度高于对照组(P<0.05)。两组产妇麻醉效果有效率为100.00%,差异无统计学意义(P>0.05)。两组产妇蛛网膜下腔注药后5、10、15、30 min的SBP、DBP较麻醉前明显下降(P<0.05);观察组产妇在蛛网膜下腔注药30 min时,HR较对照组同时间点更稳定(P<0.05),与本组麻醉前比较,差异有统计学意义(P<0.05);观察组产妇在蛛网膜下腔注药5 min时,SBP和DBP下降幅度更小,与对照组比较差异均有统计学意义(P<0.05)。观察组术后产妇对麻醉的整体满意度明显高于对照组(P<0.05)。结论0.5%布比卡因注射液混合自身脑脊液稀释麻醉可以为急诊剖宫产术提供确切的麻醉效果,保持产妇血流动力学稳定,手术医师对术中肌肉松弛满意度更高,产妇对麻醉的满意度更高。Objective To compare the muscle relaxation effects of two anesthesia schemes in emergency cesarean section.Methods A total of 80 parturients who underwent emergency cesarean section were randomly divided into observation group and control group,40 cases in each group.The observation group was given 0.5%bupivacaine injection mixed with self cerebrospinal fluid dilution anesthesia,and the control group was given 0.5%bupivacaine injection mixed with 10%glucose injection dilution anesthesia.The muscle relaxation effect,satisfaction with surgical muscle relaxation,anesthesia effect,systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)of pregnant women before anesthesia and 5,10,15,30 min after subarachnoid injection were compared between the two groups.The overall satisfaction with anesthesia of pregnant women was followed up after operation.Results There was no significant difference in the effect of muscle relaxation between the two groups when taking the fetus and closing the abdomen to suture the peritoneum(P>0.05).The satisfaction of muscle relaxation in the observation group was higher than that in the control group(P<0.05).The effective rates of anesthesia in the two groups were 100.00%,with no statistical significance(P>0.05).The SBP and DBP at 5,10,15 and 30 min after subarachnoid injection were significantly lower than those before anesthesia(P<0.05).The HR in the observation group was more stable than that in the control group at the same time point after 30 min of subarachnoid injection(P<0.05),and the difference was statistically significant when compared with that before anesthesia(P<0.05).The SBP and DBP in the observation group decreased less after 5 min of subarachnoid space injection,and the difference was statistically significant when compared with the control group(P<0.05).The overall satisfaction with anesthesia in the observation group was significantly higher than that in the control group(P<0.05).Conclusion 0.5%bupivacaine injection mixed with self cerebrospinal fluid di

关 键 词：麻醉 剖宫产 布比卡因 肌肉松弛 

分 类 号：R969.4[医药卫生—药理学]