当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2014年
1期
106-107
,共2页
布比卡因%舒芬太尼%腰-硬联合麻醉%急诊剖宫产
佈比卡因%舒芬太尼%腰-硬聯閤痳醉%急診剖宮產
포비잡인%서분태니%요-경연합마취%급진부궁산
Bupivacacine%Sufentanil%Combined spinal-epidural anesthesia%Emergency cesarean section
目的：探讨0.5%布比卡因复合舒芬太尼和单纯布比卡因腰-硬膜外联合麻醉在急诊剖宫产术的临床效果。方法60例需急诊行剖宫产产妇随机分为两组(A组和B组)，各30例，均采用腰麻-硬膜外联合麻醉，穿刺点均为L 2～3。A组蛛网膜下腔注射0.5%布比卡因1.3 mL和0.005%舒芬太尼0.5 mL混合液1.8 mL，B组为蛛网膜下腔注射0.5%布比卡因1.5 mL。记录两组麻醉效果，血压、心率变化情况，新生儿阿氏评分，术中和术后的不良反应等。结果两组均取得了满意的麻醉效果，新生儿1 min、5 min阿氏评分比较，差异无统计学意义(P＞0.05)；低血压发生率，麻黄碱使用次数和用量明显低于B组(P＜0.05)；A组发生恶心、呕吐、胸闷、寒战发生率低于B组(P＜0.05或P＜0.01)；A组术后下肢肌力恢复到Bromage评分为0分时间少于B组(P＜0.05)；但A组发生皮肤瘙痒率高于B组(P＜0.01)。结论0.5%布比卡因1.0 mL复合0.005%舒芬太尼0.5 mL腰麻-硬膜外联合麻醉在急诊剖宫产术中应用效果满意，副作用少。
目的：探討0.5%佈比卡因複閤舒芬太尼和單純佈比卡因腰-硬膜外聯閤痳醉在急診剖宮產術的臨床效果。方法60例需急診行剖宮產產婦隨機分為兩組(A組和B組)，各30例，均採用腰痳-硬膜外聯閤痳醉，穿刺點均為L 2～3。A組蛛網膜下腔註射0.5%佈比卡因1.3 mL和0.005%舒芬太尼0.5 mL混閤液1.8 mL，B組為蛛網膜下腔註射0.5%佈比卡因1.5 mL。記錄兩組痳醉效果，血壓、心率變化情況，新生兒阿氏評分，術中和術後的不良反應等。結果兩組均取得瞭滿意的痳醉效果，新生兒1 min、5 min阿氏評分比較，差異無統計學意義(P＞0.05)；低血壓髮生率，痳黃堿使用次數和用量明顯低于B組(P＜0.05)；A組髮生噁心、嘔吐、胸悶、寒戰髮生率低于B組(P＜0.05或P＜0.01)；A組術後下肢肌力恢複到Bromage評分為0分時間少于B組(P＜0.05)；但A組髮生皮膚瘙癢率高于B組(P＜0.01)。結論0.5%佈比卡因1.0 mL複閤0.005%舒芬太尼0.5 mL腰痳-硬膜外聯閤痳醉在急診剖宮產術中應用效果滿意，副作用少。
목적：탐토0.5%포비잡인복합서분태니화단순포비잡인요-경막외연합마취재급진부궁산술적림상효과。방법60례수급진행부궁산산부수궤분위량조(A조화B조)，각30례，균채용요마-경막외연합마취，천자점균위L 2～3。A조주망막하강주사0.5%포비잡인1.3 mL화0.005%서분태니0.5 mL혼합액1.8 mL，B조위주망막하강주사0.5%포비잡인1.5 mL。기록량조마취효과，혈압、심솔변화정황，신생인아씨평분，술중화술후적불량반응등。결과량조균취득료만의적마취효과，신생인1 min、5 min아씨평분비교，차이무통계학의의(P＞0.05)；저혈압발생솔，마황감사용차수화용량명현저우B조(P＜0.05)；A조발생악심、구토、흉민、한전발생솔저우B조(P＜0.05혹P＜0.01)；A조술후하지기력회복도Bromage평분위0분시간소우B조(P＜0.05)；단A조발생피부소양솔고우B조(P＜0.01)。결론0.5%포비잡인1.0 mL복합0.005%서분태니0.5 mL요마-경막외연합마취재급진부궁산술중응용효과만의，부작용소。
Objective To study the clinical effects of 0.5%bupivacaine combined with sufentanil in spinal-epidural anesthesia in emergency cesarean section. Methods 60 patients needed emergency Cesarean were randomly divided into two groups (group A and group B). There were 30 cases in each group. All were carried out combined spinal-epidural anaesthesia. The puncture point was L 2-3. The patients in group A were administrated with 0.5% bupivacaine 1.3 mL and 0.005% sufentanil 0.5 mL through subarachnoid.The patients in group A were administrated with 0.5% bupivacaine 1.5 mL through subarachnoid .The anesthetic effect, blood pressure,heart rate,neonatal Apgar scoring, intraoperative and postoperative adverse reactions in both groups were recorded.Results The effect of anesthesia in both groups were satisfactory.Neonatal 1 min,5 min Apgar scoring difference was not statistically significant (P>0.05).Low blood pressure rates,time and amount of ephedrine use in group A were significantly lower than group B (P<0.05);The incidence of nausea, vomiting, chest tightness,chills were lower than group B (P<0.05 or P<0.01);Time for the lower limb muscle strength return to Bromage 0 score was shorter in group A (P<0.05).Pruritus rate in the group A was higher than group B (P<0.01). Conclusion Application of 0.5%bupivacaine 1.0 mL combined with 0.005%fentanyl 0.5 mL in spinal-epidural anesthesia in emergency cesarean section produces certain anesthetic effect and fewer side effects.
