罗哌卡因腰硬联麻醉时不同注药速度对剖腹产麻醉效果及血流动力学的影2.docVIP

罗哌卡因腰硬联合麻醉时不同注药速度对剖腹产麻醉效果及血流动力学的影响 冯清华 何文华 廖小谊 巢月娥 【摘要】目的 比较罗哌卡因腰-硬联合麻醉时不同注药速度对剖腹产麻醉效果及血流动力学的影响。方法　180例足月妊娠剖腹产病人随机分为ABC三组，每组60例，L2～3椎间隙穿刺，穿刺成功后向蛛网膜下腔注入0.5%罗哌卡因2ml.，注药速度： A组为15s，B组为35s，C组为50s。观察（1）感觉阻滞平面到达T10的时间和最高感觉阻滞平面；（2）进行麻醉质量评价；（3）运动阻滞评级；（4）蛛网膜下腔注药后5，10，15分钟BP、HR、SPO2变化，并与基础值对比；（5）恶心呕吐，神经并发症等副作用。结果 感觉阻滞平面到达T10的时间A组和 B组相近（P＞0.05），B组快于C组（P＜0.01）；最高感觉阻滞平面A组最高，C组最低；麻醉质量评价三组都优良；运动阻滞三组均为2分；三组注药后15分钟所测到的血压值最低，与基础值比较A组明显(P＜0.05)，B组和C组也有一定下降（P＞0.05）；对HR和SPO2无明显影响；无恶心呕吐和神经并发症出现。结论 罗哌卡因腰硬联合麻醉时三种注药速度用于剖腹产手术麻醉效果理想，减慢输注速度对血流动力学影响更小。 【关键词】罗哌卡因 腰-硬联合麻醉 剖腹产 麻醉效果 血流动力学 Ropivacaine spinal and epidural anesthesia on cesarean section rate of different injection anesthesia and hemodynamicsFENG Qing-hua LIAO Xiao-Yi HEWen-Hua .(County Peoples Hospital, Guangzhou, Guangdong Province 526300.CHINA 【Abstract】 Objective 　To compare ropivacaine spinal and epidural anesthesia during cesarean section with different injection rate on anesthesia and hemodynamics. Methods 　180 cases of cesarean section in term pregnancy were randomly divided into the ABC three groups of 60 cases, L2 ～3 intervertebral disc puncture, puncture after the success of the subarachnoid injection of 0.5% 广东省广宁县人民医院526300 ropivacaine 2ml., Injection speed: A group for the 15s, B group, 35s, C group 50s. Observation (1) to reach T10 sensory block of time and peak sensory block; (2) to evaluate the quality of anesthesia; (3) motor block rating; (4) after subarachnoid injection 5,10,15 minutes of BP, HR, SPO2 changesAnd compared with baseline; (5) nausea and vomiting, neurological complications and other side effects. Results　of sensory block reached T10 time A group and B group are similar (P ＞0.05), B group faster than the C group (P＜0.01); the highest group had the highest sensory block A, C group was the lowest; anesthesia Quality Assessment 3 groups are good; motor block were three 2 min; three groups 15 minutes after injection, the lowest blood pressure measured, with values A were significantly (P ＜0.05), B