中国现代药物应用
中國現代藥物應用
중국현대약물응용
CHINESE JOURNAL OF MODERN DRUG APPLICATION
2014年
21期
1-3
,共3页
罗哌卡因%硬膜外阻滞%剖宫产
囉哌卡因%硬膜外阻滯%剖宮產
라고잡인%경막외조체%부궁산
Ropivacaine%Epidural block%Cesarean delivery
目的：探讨罗哌卡因与布比卡因、利多卡因硬膜外阻滞麻醉对产妇及新生儿的影响。方法拟在硬膜外阻滞麻醉下行剖宫产术的产妇718例,随机分为三组, R组(n1=254)注射0.5%盐酸罗哌卡因；B组(n2=264)注射0.5%盐酸布比卡因；L组(n3=200)注射2%盐酸利多卡因。采用序贯法进行。结果对三组硬膜外阻滞效果；药物的不良反应；阻滞完善后血压变化；新生儿出生时Apgar评分等进行临床观察,R组阻滞效果好于B组和L组。三种麻醉药不良反应：R组<B组<L组；阻滞完善后血压下降明显R组<B组<L组。新生儿Apgar评分R组高于B组及L组(P<0.05)。结论罗哌卡因比布比卡因、利多卡因较少发生中枢神经系统及心血管的蓄积,罗哌卡因在体内消除代谢能力较强,半衰期短,对子宫和胎盘血流几乎无影响,是剖宫产术麻醉效果好且安全的麻醉药。
目的：探討囉哌卡因與佈比卡因、利多卡因硬膜外阻滯痳醉對產婦及新生兒的影響。方法擬在硬膜外阻滯痳醉下行剖宮產術的產婦718例,隨機分為三組, R組(n1=254)註射0.5%鹽痠囉哌卡因；B組(n2=264)註射0.5%鹽痠佈比卡因；L組(n3=200)註射2%鹽痠利多卡因。採用序貫法進行。結果對三組硬膜外阻滯效果；藥物的不良反應；阻滯完善後血壓變化；新生兒齣生時Apgar評分等進行臨床觀察,R組阻滯效果好于B組和L組。三種痳醉藥不良反應：R組<B組<L組；阻滯完善後血壓下降明顯R組<B組<L組。新生兒Apgar評分R組高于B組及L組(P<0.05)。結論囉哌卡因比佈比卡因、利多卡因較少髮生中樞神經繫統及心血管的蓄積,囉哌卡因在體內消除代謝能力較彊,半衰期短,對子宮和胎盤血流幾乎無影響,是剖宮產術痳醉效果好且安全的痳醉藥。
목적：탐토라고잡인여포비잡인、리다잡인경막외조체마취대산부급신생인적영향。방법의재경막외조체마취하행부궁산술적산부718례,수궤분위삼조, R조(n1=254)주사0.5%염산라고잡인；B조(n2=264)주사0.5%염산포비잡인；L조(n3=200)주사2%염산리다잡인。채용서관법진행。결과대삼조경막외조체효과；약물적불량반응；조체완선후혈압변화；신생인출생시Apgar평분등진행림상관찰,R조조체효과호우B조화L조。삼충마취약불량반응：R조<B조<L조；조체완선후혈압하강명현R조<B조<L조。신생인Apgar평분R조고우B조급L조(P<0.05)。결론라고잡인비포비잡인、리다잡인교소발생중추신경계통급심혈관적축적,라고잡인재체내소제대사능력교강,반쇠기단,대자궁화태반혈류궤호무영향,시부궁산술마취효과호차안전적마취약。
Objective To explore the influence of epidural block anesthesia by ropivacaine, bupivacaine and lidocaine on puerpera and newborn in cesarean delivery. Methods A total of 718 puerpera, who would undergo cesarean delivery with epidural block anesthesia, were randomly divided into three groups. Group R (n1=254) took injection of 0.5%ropivacaine hydrochloride, group B (n2=264) took injection of 0.5%bupivacaine hydrochloride, and group L (n3=200) took injection of 2% lidocaine hydrochloride. Sequential method was applied in the anesthesia as fractional injection of small dose of narcotics. Results Clinical observations were made on the effects of epidural block anesthesia, adverse reactions of drugs, blood pressure changes after block, and neonatal Apgar score of the three groups. The blocking effect of group R was better than that of group B and group L. The result of adverse reactions of drugs of the three groups was group R<group B<group L. The result of blood pressure changes after block of the three groups was group R<group B<group L. The neonatal Apgar score of group R was higher than that of group B and group L (P<0.05). Conclusion Ropivacaine has lower incidence of accumulation in central nervous system and angiocarpy than bupivacaine and lidocaine;it has shorter half-life period, and is easier to be metabolized. Ropivacaine has rarely little influence on bloodstream in uterus and placenta, therefore it is an effective and safe narcotic for the anesthesia in cesarean delivery.
