较小剂量布比卡因一芬太尼腰麻行急诊剖宫产术.DOCVIP

临床医学论文-较小剂量布比卡因一芬太尼腰麻行急诊剖宫产术 【关键词】? 布比卡因;,,芬太尼;,,腰麻;,,剖宫产术 　　摘要：目的：探讨较小剂量布比卡因复合芬太尼腰麻行剖宫产术的临床效应。方法：40列行急诊剖宫产术的临产妇，随机双盲分为两组：BF组腰麻用药为布比卡因8mg加芬太尼20ug(n=20)；BS组布比卡因10mg(n=20)。观察两组用药后的MAP、SBP和HR变化、新生儿APgar评分、麻醉效果及不良反应。结果：BS组MAP比BF组下降更加显著，BS组低血压发生率明显高于BF组（P0.01）；两组新生儿APgar评分无差异（P0.05）；BF组麻醉效果明显优于BS组（P0.01）;两组不良反应无明显差异。结论：较小剂量布比卡因复合芬太尼腰麻行急诊剖宫产术，麻醉效果确切，低血压发生率低且不良反应少。 　　关键词:? 布比卡因;? 芬太尼;? 腰麻;? 剖宫产术 　　Lower-dose Bupivacaine-fentanyl Spinal Anesthesia for Urgent? Cesarean? Section 　　Abstract:? Objective:?? To? study?the?clinical?effectiveness of?lower-dose?bupivacaine-fentanyl?spinal?anesthesia?for?cesarean?section.Method: In?this?randomized,?double-blind?study,?40?parturient?women?were?allocated?to?one?of?two?groups:?group?BF, receiving?8mg?bupivacaine?+20ug?fentanyl(n=20)?and?group?BS, 10mg?bupivacaine?(n=20).MAP,?SBP,?HR,?Apgar?scores?of?newborn,?anesthetic?effects?and?side?effects?were?observed.?Result:?The?decrease?of?MAP?was?greater?in?group?BS?compared?with?that?in?group?BF.The?incidence?of?hypopiesia?was?higher?in?group?BS?compared?with牋 that?in?group?BF(p0.01).?There?was?no牋 significant?difference?in?the?Apgar?scales?of?newborns?between?the?two?groups(p0.05).?The?effect?of?anesthesia?in?group?BS?was?significanfly?better than?that?in?group?BF(p0.01).There?was no?significant?difference?in?the?side?effects?between?the?two?groups.?Conclusion:?There?are?better?effect?of?anesthesia?and lower? incidence? of? hypopiesia? and? fewer? side? effects? in? spinal? anesthesia? with? lower-dose? bupivacaine-fentanyl? for? urgent? cesarean? section. 　　Key? words:? Bupivacaine;? Fentanyl;? Spinal? anesthesia;? Cesarean? section ??? 本研究采用较小剂量布比卡因复合芬太尼与单用布比卡因对比来探讨临床实用性和优越性。 　　1? 资料与方法 　　1.1? 一般资料：40例ASAI～Ⅱ级行横切口急诊剖宫产术的临产妇，术前均无特殊妊娠合并症，随机分为较小剂量布比卡因一芬太尼组（BF组，20例）和单纯布比卡因组（BS组，20例）。 　　1.2? 麻醉方法：术前30min肌注阿托品0.5mg，麻醉前快速静脉输注复方乳酸钠10ml/kg,并常规鼻导管吸氧3L/min。均取右侧卧位于L2～3间隙硬膜外穿刺成功后