CAJ | 학술논문

目的:探讨盐酸利多卡因、盐酸左布比卡因、甲磺酸罗哌卡因在剖宫产患者硬膜外腔的弥散效果.方法:择期拟行剖宫产手术的患者90例,年龄20~35岁,无连续硬膜外腔麻醉禁忌证,既往无椎管内麻醉史,ASA分级Ⅰ~Ⅱ级.采用随机数字表法分为三组(n=30):2%利多卡因组(A组)、0.5%左布比卡因组(B组)、0.894%罗哌卡因组(C组).三组均采用2%利多卡因3 ml作为实验量,追加量3~5 ml/次,间隔5 min分次给予,阻滞范围达S3~5~T8~6时停止给药,开始手术.比较各组手术开始时局麻药用量,观察胎儿娩出后10 min各组感觉平面阻滞范围,肌松程度、新生儿阿氏评分.结果:A组及C组手术开始时用药量均显著低于B组(P<0.05);胎儿娩出后10 min,C组感觉平面阻滞范围显著高于B组(P<0.05),但与A组比较差异无统计学意义;术中肌松效果B、C组均显著优于A组(P<0.05),B组和C组比较差异无统计学意义;三组新生儿阿氏评分比较差异无统计学意义.结论:利多卡因与罗哌卡因在剖宫产患者硬膜外腔的弥散效果均优于左布比卡因,但罗哌卡因的肌松效果显著优于利多卡因,三种局麻药上述用量时对新生儿阿氏评分的影响无统计学差异.
목적:탐토염산리다잡인、염산좌포비잡인、갑광산라고잡인재부궁산환자경막외강적미산효과.방법:택기의행부궁산수술적환자90례,년령20~35세,무련속경막외강마취금기증,기왕무추관내마취사,ASA분급Ⅰ~Ⅱ급.채용수궤수자표법분위삼조(n=30):2%리다잡인조(A조)、0.5%좌포비잡인조(B조)、0.894%라고잡인조(C조).삼조균채용2%리다잡인3 ml작위실험량,추가량3~5 ml/차,간격5 min분차급여,조체범위체S3~5~T8~6시정지급약,개시수술.비교각조수술개시시국마약용량,관찰태인면출후10 min각조감각평면조체범위,기송정도、신생인아씨평분.결과:A조급C조수술개시시용약량균현저저우B조(P<0.05);태인면출후10 min,C조감각평면조체범위현저고우B조(P<0.05),단여A조비교차이무통계학의의;술중기송효과B、C조균현저우우A조(P<0.05),B조화C조비교차이무통계학의의;삼조신생인아씨평분비교차이무통계학의의.결론:리다잡인여라고잡인재부궁산환자경막외강적미산효과균우우좌포비잡인,단라고잡인적기송효과현저우우리다잡인,삼충국마약상술용량시대신생인아씨평분적영향무통계학차이.
Objective:To investigate the epidural dispersion effects of the lidocaine hydrochloride,hydrochloric acid levobupivacaine,and ropivacaine mesylate in cesarean section patients. Method:Ninety ASAⅠ-Ⅱcesarean section patients of aged 20-35 years old,no continuous epidural anesthesia contraindications,who had no history of spinal anesthesia,were selected in the study. They were randomly divided into three groups(n=30):2%lidocaine group(group A),0.5%levobupivacaine group(group B),0.894%ropivacaine group(group C). All the patients were given 2%lidocaine 3 ml as experimental dosage,and the patients were given corresponding local anaesthetic every time 3-5 ml interval 5 min,block ranged to S3-5-T8-6, stopped to medicine and start the operation. To Compare local anesthetic dosages of three groups before operation,observed the block range of the three groups after 10 min the baby delivered,the muscle relaxation degree,neonatal Apgar score. Result:Local anaesthetic dosages of the group A and group C were significantly lower than the group B(P<0.05). The block range of group C after 10 min the baby delivered was significantly higher than that of group B(P<0.05),with no significant difference compared with group A. The muscle relaxation degree of group B and group C was significantly better than group A(P<0.05),with no significant difference between group B and group C. Neonatal Apgar scores of the three groups were not statistically different. Conclusion:Lidocaine and ropivacaine display superior epidural dispersion effects than levobupivacaine in cesarean section. The muscle relaxation effect of ropivacaine is significantly superior to lidocaine. Three local anesthetics above dosage are no significant effect on neonatal Apgar score.