不同比重布比卡因腰硬联合麻醉在妊娠高血压综合征剖宫产中的应用  

Application of Different Specific Weight Bupivacaine Combined With Epidural Anesthesia in Cesarean Section With Pregnancy-Induced Hypertension Syndrome

作　　者：马雪 陈新院 刘欢 MA Xue;CHEN Xinyuan;LIU Huan(Department of Anesthesiology,Fuzhou Fuxing Maternity Hospital,Fuzhou Fujian 350014,China)

机构地区：[1]福州福兴妇产医院麻醉科,福建福州350014

出　　处：《中国卫生标准管理》2024年第12期149-153,共5页China Health Standard Management

摘　　要：目的探讨不同比重布比卡因腰硬联合麻醉对妊娠高血压综合征剖宫产孕妇血流动力学的影响。方法选择2022年1—12月在福州福兴妇产医院行腰硬联合麻醉的90例剖宫产妊娠高血压综合征产妇为研究对象。根据麻醉方案不同分为轻比重组、等比重组、重比重组,各30例。其中,在蛛网膜下腔麻醉给药中,轻比重组给予0.75%布比卡因2 mL+1 mL无菌注射用水;等比重组予0.75%布比卡因2 mL+1 mL 0.9%氯化钠溶液;重比重组予0.75%布比卡因2 mL+1 mL 10%葡萄糖溶液。比较3组产妇麻醉前、麻醉5、15 min血流动力学相关指标变化、麻醉效果及麻醉不良反应发生情况。结果3组麻醉5、15 min后的心率、平均动脉血压比较,差异有统计学意义(P<0.05);等比重组、重比重组麻醉5、15 min后的心率、平均动脉血压低于麻醉前,差异有统计学意义(P<0.05);重比重组麻醉5、15 min后的心率、平均动脉血压与轻比重组、等比重组比较,差异有统计学意义(P<0.05)。等比重组感觉阻滞起效时间为(3.23±0.94)min、运动阻滞起效时间为(5.33±1.06)min,重比重组的感觉阻滞起效时间为(3.17±1.21)min、运动阻滞起效时间为(5.13±1.22)min,均短于轻比重组的(4.73±1.02)min、(6.50±1.08)min,差异有统计学意义(P<0.05)。3组感觉阻滞、运动阻滞维持时间比较,差异无统计学意义(P>0.05)。3组麻醉总有效率比较,差异无统计学意义(P>0.05)。重比重组麻醉不良反应总发生率为20.00%,高于轻比重组的0、等比重组的3.33%,差异有统计学意义(P<0.05)。结论妊娠高血压综合征剖宫产孕妇术中应用等比重布比卡因腰硬联合麻醉能够获得良好的麻醉效果,且对患者机体血流动力学、不良反应影响较小。Objective To explore the effect of combined spinal epidural anesthesia with Bupivacaine of different specific gravity on the hemodynamics of pregnant women undergoing caesarean section with pregnancy-induced hypertension syndrome.Methods A total of 90 pregnant women with pregnancy-induced hypertension syndrome undergoing cesarean section who underwent lumbar epidural anesthesia at Fuzhou Fuxing Maternity Hospital from January to December 2022 were selected as the study subjects.According to different anesthesia plans,there are 30 cases of light specific gravity group,30 cases of equal specific gravity group,and 30 cases of heavy specific gravity group.In the administration of subarachnoid anesthesia,light specific gravity group was given 0.75%bupivacaine 2 mL+1 mL sterile water for injection.Isobaric specific gravity group was given 0.75%bupivacaine 2 mL+1 mL 0.09%sodium chloride solution.Heavy specific gravity group was given 0.75%bupivacaine 2 mL+1 mL 10%glucose solution.The changes of hemodynamic indexes,anesthesia effect and the occurrence of adverse reactions before anesthesia,5 and 15 min were compared among the three groups.Results There were significant differences in heart rate and mean arterial blood pressure 5 and 15 min after anesthesia among the three groups(P<0.05).The heart rate and mean arterial blood pressure after 5 and 15 min of equal specific gravity group and heavy specific gravity group were lower than those before anesthesia,and the differences were statistically significant(P<0.05).The heart rate and mean arterial blood pressure after 5 and 15 min of heavy specific gravity group were significantly different from those of light specific gravity group and equal specific gravity group(P<0.05).The onset time of sensory block was(3.23±0.94)min and motor block was(5.33±1.06)min for equal specific gravity group,(3.17±1.21)min and(5.13±1.22)min for heavy specific gravity group,which were all shorter than(4.73±1.02)min and(6.50±1.08)min of light specific gravity group,and the difference was s

关 键 词：妊娠高血压综合征 剖宫产 布比卡因 等比重 腰硬联合麻醉 血流动力学 

分 类 号：R614[医药卫生—麻醉学]