0.3%罗比卡因液腰麻在剖宫产手术中的应用  

Low consistency spinal ropivacaine for cesarean delivery:a comparision to hyperbaric and plain

作　　者：曾玲双[1] 王学斌[1] 李忠田[1] 杨晨[1] 杨学锋[1] 杨力琼[1] 

机构地区：[1]宁夏银川市第一人民医院,宁夏银川750001

出　　处：《宁夏医学杂志》2004年第5期284-286,共3页Ningxia Medical Journal

摘　　要：目的观察罗比卡因低浓度液腰麻对循环的影响和麻醉效果。方法剖宫产产妇150例,随机分为3组,每组50例。低浓度组(A组):0.75%罗比卡因2ml+注射用水3ml。重比重组(B组):0.75%罗比卡因2ml+10%葡萄糖1ml。原液组(C组):0.75%罗比卡因2ml。腰硬联合技术L3-4间隙一针法穿刺,腰麻注药速度1ml/10s。结果低浓度液腰麻平面固定快(P<0.001)。平面集中在T6-4之间(P<0.001)。感觉运动阻滞作用消退快(P<0.001)。麻醉效果与同剂量重比重液相同(F=2.205,P=0.332)。麻醉后血压心率变化轻(P=0.001和P=0.003),低血压的发生率低(χ2=24.419,P=0.000)。结论0.3%罗比卡因15mg低浓度液腰麻可获得同剂量0.5%重比重液腰麻相同的效果。麻醉平面固定快、平面扩散集中、麻醉作用消退快,运动阻滞程度轻。麻醉后血压心率变化轻,低血压的发生率低。具有轻比重液腰麻的特点。Objective To observe the chang of circulation and the effect of anesthesia for the low consistency of Ropivacaine on the spinal anesthesia.Methods One hundred fifty ASA I-II patients were undergo cesarean delivery.Patients were randomized to receive a dose of spinal Ropivacaine :0.75% Ropivacaine 2ml (n=50) , 0.75% Ropivacaine 2ml+10%GS 1ml diluted to 3 ml (n=50),0.75% Ropivac-aine 2ml+sterile water 3ml diluted to 5 ml (n=50). L 3 4 via a combined spinal/epidural technique in the left lateral position. The speed of intrathecally was 1ml/10s.Sensory changed to pinprick and motor block (Bromage score) were recorded.Results The maximum upper spread of sensory block were more faster in the low consistency group 11.7±1.2min(P<0.001) ,it concentrated at T 6( T 6-4 ) P<0.001 . Offset of motor and sensory block was rapid in the low consistency group 82.7± 9 .4 min and 102.5 ±20.2 min(P<0.001) .The effect of anesthesia was same in the three group (P> 0.05). The chang of blood pressure and heart rate was small in the low consistency group(P<0.05).Conclusion To compare with 15 mg of 0.5% hyperbaric ropivacaine when administer for cesarean delivery. Implications:15 mg of 0.3% ropivacaine can provid effective spinal anesthesia with shorter duration of sensory and motor block.

关 键 词：罗比卡因 比重 腰麻 浓度 

分 类 号：R614.3[医药卫生—麻醉学]