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.pdfVIP

四川医学 20 4 年 0 月第 35 卷(第 0 期) Sichuan Medical Journal,20 4,Vol 35,No 0 论著 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 朱玉霖 (彭州市人民医院麻醉科,四川 彭州 611930) 【摘要】 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。 【关键词】 小剂量;低位脊麻;低容量;硬腰外麻醉;剖宫产;心血管系统 【中图分类号】 R 713. 14 【文献标志码】 A 【文章编号】 1004 0501(2014)10 1285 03 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. Zhu Yulin. Peng- zhou People’s Hospital,Pengzhou,Sichuan 611930,China 【Abstract】 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 ( SPO 2 ),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