CAJ | 학술논문

目的：评估0．5％等比重左旋布比卡因10 mg与0．5％重比重布比卡因10 mg腰硬联合麻醉用于剖宫产的临床效果。方法将60例ASAⅠ～Ⅱ级择期剖宫产的产妇随机分为2组，每组30例。 LF组用0．5％等比重左旋布比卡因10 mg进行腰硬联合麻醉；BF组用0．5％重比重布比卡因10 mg腰硬联合麻醉。用针刺皮肤法和改良运动阻滞（Bromage）分级法评估2组感觉和运动阻滞情况，观察并记录2组血流动力学变化和不良反应发生情况。结果 LF组达到最大感觉阻滞时间、感觉阻滞消退时间以及感觉阻滞消退平面达T12的时间均短于BF组，BF组运动阻滞发展的更快，持续时间更长；LF组低血压、心动过缓、恶心的发生率低于BF组（P均＜0．05）。结论0．5％等比重左旋布比卡因10 mg腰硬联合麻醉用于剖宫产产生的运动阻滞时间更短，低血压、心动过缓、恶心的不良反应发生率更低，是剖宫产腰硬联合麻醉一个更好的替代方法。
목적：평고0．5％등비중좌선포비잡인10 mg여0．5％중비중포비잡인10 mg요경연합마취용우부궁산적림상효과。방법장60례ASAⅠ～Ⅱ급택기부궁산적산부수궤분위2조，매조30례。 LF조용0．5％등비중좌선포비잡인10 mg진행요경연합마취；BF조용0．5％중비중포비잡인10 mg요경연합마취。용침자피부법화개량운동조체（Bromage）분급법평고2조감각화운동조체정황，관찰병기록2조혈류동역학변화화불량반응발생정황。결과 LF조체도최대감각조체시간、감각조체소퇴시간이급감각조체소퇴평면체T12적시간균단우BF조，BF조운동조체발전적경쾌，지속시간경장；LF조저혈압、심동과완、악심적발생솔저우BF조（P균＜0．05）。결론0．5％등비중좌선포비잡인10 mg요경연합마취용우부궁산산생적운동조체시간경단，저혈압、심동과완、악심적불량반응발생솔경저，시부궁산요경연합마취일개경호적체대방법。
Objective It is to investigation the efficacy and safety of combined spinal -epidural anesthesia ( CSEA) with i-sobaric levobupivacaine and hyperbaric bupivacaine for cesarean sections .Methods Sixty primiparaes ( ASAⅠ Ⅱ) sched-ualed for elective caesarean section were divided into two groups with 30 cases each.Isobaric levobupivacaine group (LFgroup) received 0.5%isobaric levobupivacaine 10mg;Hyperbaric bupivacaine group ( BFgroup) received 0.5% hyperbaric bupiva-caine10mg.Sensory and motor block characteristics of the groups were assessed with pinprick and Bromage scale ; Hemody-namic changes and side effects were observed and recorded in both groups .Results The time to reach maximum dermatome for the sensory block, time to regression and time to regress to T12 dermatome was found to be significantly long in Group BF .It was observed that in Group BF , the evolution of the motor block was faster and lasted longer .Whereas hypotension , bradycar-dia and nausea were less in Group LF(P<0.05).Conclusion Since motor block time is shorter, and side effects like hypo-tension, bradycardia and nausea are less ,levobupivacaine for combined spinal-epidural anesthesia can be a good alternative in cesarean sections .