罗比卡因蛛网膜下隙阻滞用于剖宫产的量-效关系  

Dose-effect relationship of ropivacaine spinal anesthesia for Caesarean section

作　　者：于涛[1] 高崇荣[1] 卢振和[1] 谢广沂[1] 王海龙 

机构地区：[1]广州医学院附属第二医院麻醉科,广州市510260 [2]广州市新海医院疼痛科

出　　处：《临床麻醉学杂志》2004年第2期92-94,共3页Journal of Clinical Anesthesiology

摘　　要：目的　探讨罗比卡因在剖宫产蛛网膜下隙阻滞中的量 效关系。方法　 6 0例行择期剖宫产术的初产妇随机分为三组 ,分别接受 10、15、2 0mg的同容量 (3ml)、同比重 (1.0 2 2 ,37℃ )罗比卡因腰麻液 ,观察温度觉、痛觉及下肢运动阻滞的起效和持续时间、温度和痛觉的最高阻滞平面、腹肌松弛度、新生儿Apgar评分及脐动脉血血气、低血压、心动过缓及神经系统不良反应 (术后 4 8h内 )发生情况。结果　温痛觉及下肢运动阻滞时间随剂量增加而逐渐延长 (P <0 0 5 ) ;Ⅰ组Bromage评分明显低于Ⅱ、Ⅲ组 (P <0 0 5 ) ;腹肌松弛度Ⅱ、Ⅲ组优于Ⅰ组 (P <0 0 5 ) ;其余指标三组间无统计学差异 (P >0 0 5 ) ;三组均未观察到明显神经系统不良反应。结论　 15mg罗比卡因重比重腰麻液应用于剖宫产蛛网膜下隙阻滞 ,可达较完善的临床效果 。Objective To investigate the dose-effect relationship of ropivacaine spinal anesthesia for Caesarean section.Methods Sixty parturients scheduled for elective Caesarean section were enrolled into three groups with 20 cases each. A dose of 10mg hyperbaric ropivacaine in 3 ml was given in group Ⅰ,15mg in group Ⅱ,and 20mg in group Ⅲ. Observation included the onset time and duration of sensory(temperature and pain) block and motor block of the lower limb and abdominal muscle, the maximum plane of sensory block, Apgar score , blood-gas analysis of the umbilical artery, incidence of hypotension and bradycardia, occurrence of neurological complications within 48 hours postoperatively.Results The duration of sensory and motor blockade prolongs as the dose increases. Bromage scale in groupⅠwas lower than that in group ⅡandⅢ (P<0.05). The relaxation of abdominal muscle in group ⅡandⅢ was better than that in group Ⅰ(P<0.05). No obvious neurological complications were founded.Conclusion Spinal anesthesia with 15mg hyperberic ropivacaine can be used safely and sufficiently for Caesarean section.

关 键 词：罗比卡因 蛛网膜下隙阻滞 剖宫产 量-效关系 手术 麻醉 

分 类 号：R614[医药卫生—麻醉学]