CAJ | 학술논문

目的：观察小剂量布比卡因低位脊麻联合低容量硬膜外麻醉对剖宫产术中产妇心血管系统的影响。方法60例拟行剖宫产的足月产妇,ASA分级为Ⅰ~Ⅱ级,随机均分为试验( E)、对照( C)两组。两组均选择腰3~4间隙穿刺注入0.5%布比卡因脊麻,E组使用1.5mL后硬膜外给予2%利多卡因6mL联合麻醉,C组使用2mL以同样方式硬膜外给予生理盐水各3mL。观察脊麻后5min、10min、15min时收缩压(SBP)、心率(HR)变化；麻醉后低血压、心动过缓、牵拉反应发生率及肌松效果。结果两组麻醉后SBP均低于麻醉前(P<0.05),且E组在麻醉后5min、10min时高于C组(P<0.05)。 HR均高于麻醉前,且E组在麻醉后5min、10min时低于C组(P<0.05)。麻醉后E组低血压发生率明显低于C组(P<0.05)；心动过缓、牵拉反应发生率及肌松效果两组间差异无统计学意义(P>0.05)。结论小剂量布比卡因低位脊麻联合低容量硬膜外麻醉可有效稳定剖宫产术中产妇心血管系统。
목적：관찰소제량포비잡인저위척마연합저용량경막외마취대부궁산술중산부심혈관계통적영향。방법60례의행부궁산적족월산부,ASA분급위Ⅰ~Ⅱ급,수궤균분위시험( E)、대조( C)량조。량조균선택요3~4간극천자주입0.5%포비잡인척마,E조사용1.5mL후경막외급여2%리다잡인6mL연합마취,C조사용2mL이동양방식경막외급여생리염수각3mL。관찰척마후5min、10min、15min시수축압(SBP)、심솔(HR)변화；마취후저혈압、심동과완、견랍반응발생솔급기송효과。결과량조마취후SBP균저우마취전(P<0.05),차E조재마취후5min、10min시고우C조(P<0.05)。 HR균고우마취전,차E조재마취후5min、10min시저우C조(P<0.05)。마취후E조저혈압발생솔명현저우C조(P<0.05)；심동과완、견랍반응발생솔급기송효과량조간차이무통계학의의(P>0.05)。결론소제량포비잡인저위척마연합저용량경막외마취가유효은정부궁산술중산부심혈관계통。
Objective To observe the effects of cardiovascular system on cesarean section patients after the lower lumber interspaces anesthesia that small doses of bupivacaine for spinal anesthesia combined with low capacity of epidural anesthesia. Methods 60 termed parturients(ASA I-II)for cesarean section were randomly divided into Experimental(E,n=30)group and Contrast(C,n=30)group. Spinal anesthesia for the parturients are performed at the 3-4 of lumber interspaces by injecting 1. 5mL of 0. 5% Bupivacaine in group E,and 2mL in group C. Observe the several experimental index of two groups cesarean after spinal anesthesia in 5min,10min and 15min,that include systolic blood pressure(SBP),pulse oxygen saturation(SPO2),heart rate ( HR) . Meanwhile others experimental index such as the incidence of hypotension,bradycardia,traction response and effectiveness of muscle relaxation. Results The SBP of two groups after anesthesia are lower than those before anesthesia(P<0. 05),and the SBP of group E is higher than group C in 5 and 10min after anesthesia(P<0. 05). The HR of the two groups are increased signifi-cantly after anesthesia than before(P<0. 05),and that in the group E is lower than group C in 5 and 10min after anesthesia. After anesthesia,the incidence of hypotension in group E is the lower than group C respective(P<0. 05);and it is no significant differ-ences in the two groups that the incidence of bradycardia and traction response and that the effectiveness of muscle relaxation( P>0. 05). Conclusion It can effectively stabilize cesarean section patients in cardiovascular system that lower lum-ber interspaces anesthesia by small doses of bupivacaine for spinal anesthesia combined with low capacity of epidural anesthesia.