小剂量布比卡因腰部麻醉在剖宫产术中的麻醉效果分析.docVIP

小剂量布比卡因腰部麻醉在剖宫产术中的麻醉效果分析 　　作者：康吉龙，崔峰鹤 作者单位：延边大学附属医院 麻醉科，吉林 延吉 　　【摘要】 [背景]观察小剂量布比卡因蛛网膜下腔阻滞(腰部麻醉)在剖宫产术中的麻醉效果.[病例报告]选择50例剖宫产术患者，随机分成观察组和对照组，每组各为25例.观察组注入药物为7.5g/L布比卡因1.0mL加脑脊液1.0mL，对照组为7.5g/L布比卡因1.5mL加250g/L葡萄糖溶液0.3mL加脑脊液0.2mL.观察患者术中最高麻醉平面、血压变化、镇痛效果及恶心呕吐等表现.所有患者镇痛效果良好，未使用镇痛药等其他辅助药物，与麻醉前比较观察组及对照组患者血压均下降，但观察组患者收缩压维持在13.3kPa以上，不需升压处理，而对照组患者血压较低，收缩压下降至13.3kPa以下，需行快速补液或静脉推注麻黄碱等升压药.[讨论]给剖宫产术患者实施小剂量布比卡因行蛛网膜下腔阻滞可获得满意的镇痛效果，且对血压的影响较小，恶心及呕吐等副作用较少见，是比较安全且有效的麻醉方法. 　　【关键词】 麻醉;蛛网膜下腔;比重;剖宫产术 　　Analysis for spinal anesthesia with minidose of normoberic bupivacaine in cesarean section 　　KANG Jilong, CUI Fenghe 　　(Department of Anesthesiology, Affiliated Hospital of Yanbian University, Yanji 133000, Jilin, China) 　　ABSTRACT:BACKGROUNDTo observe the effects of minidose of bupivacaine for spinal anaesthesia in cesarean section.CASE REPORTSFifty patients with undergoing cesarean section were randomly divided into observation group and control group, there were 25 casee in per group.The patients in observation group were injected 7.5g/L of bupivacaine 1.0mL and cerebrospinal fluid 1.0mL, and control group was injected 7.5g/L of bupivacaine 1.5mL, 250g/L of glucose solution 0.3mL and cerebrospinal fluid 0.2mL. The highest level of block and side effects such as panting, nausea, vomiting and traction reflex of the gravide were also observed.The two mixtures of bupivacaine can produce satisfactory spinal anesthesia for cesarean, none used any painkiller. The blood pressure decreased significantly after anesthesia in both groups, but the blood pressure of observation group was maintained above 13.3kPa, needed no deal. The blood pressure of the control group decreased significantly after anesthesia below 13.3kPa, needed to transfuse fluid replacement quickly or infuse pressor agent to intravenous par example ephedrine.DISCUSSIONMinidose isobaric of bupivacaine can produce satisfactory spinal anesthesia for cesarean section and has little effect on blood pressure .The si