舒芬太尼复合小剂量罗哌卡因腰麻在宫腔镜手术中的应用.docVIP

精品论文 参考文献 舒芬太尼复合小剂量罗哌卡因腰麻在宫腔镜手术中的应用 吴铭广1刘卫锋2黄晓雷1史晓勇1李元涛1 (1. 南方医科大学附属深圳妇幼保健院麻醉科深圳518028; 2. 中山大学附属第一医院麻醉科广州510080) 作者简介：吴铭广(1976.10-),男,本科,主治医师,研究方向：妇产科麻醉、产科镇痛。主要研究妇产科麻醉。通讯作者：李元涛。 【摘要】目的：探讨舒芬太尼复合小剂量罗哌卡因腰麻用于宫腔镜手术的可行性。方法：180例拟在腰麻下行宫腔镜手术患者随机分为三组，每组60例。R10组给予罗哌卡因10mg，R5组给予罗哌卡因5mg，RS组给予罗哌卡因5mg+舒芬太尼4mu;g，三组均选L2-3间隙穿刺，用脑脊液稀释至2ml，针口朝头，注药时间8秒。监测记录患者循环功能、感觉阻滞程度、运动阻滞程度及不良反应。结果：RS组与R10组相比，感觉阻滞平面、麻醉效果优良率无显著性差异，用药后R10组血压下降、心率减慢(Plt;0.01)，但RS组变化不明显，RS组用药后60min Bromage评分高于R10组(Plt;001),运动阻滞程度明显轻于R10组；RS组与R5组相比，两组用药后血压、心率变化均不明显，用药后60min Bromage评分无显著性差异，但RS组感觉阻滞平面、麻醉效果优良率高于R5组(Plt;0.01)。结论：舒芬太尼(4mu;g) 复合小剂量罗哌卡因（5mg）腰麻用于宫腔镜手术感觉阻滞完善、麻醉效果满意，对血流动力学影响小，运动阻滞轻，不良反应少。 【关键词】舒芬太尼；罗哌卡因；腰麻；宫腔镜手术 【中图分类号】R713.4【文献标识码】A【文章编号】1008-6455（2010）08-0241-02Application of Sufentanil combined with Low-dose Ropivacaine for spinal anesthesia in hysteroscope operation Wu Mingguang1Liu Weifeng2Huang Xiaolei1 et al. 【Abstract】Objective: To explore the feasibility of Sufentanil combined with Low-dose Ropivacaine for spinal anesthesia in hysteroscopic surgery. Methods: 180 cases is intended to be down in hysteroscopic surgery of spinal anesthesia were randomly divided into three groups, each group of 60 cases,R10 group received ropivacaine 10mg, R5 group received ropivacaine 5mg, RS group received ropivacaine 5mg + sufentanil 4mu;g, the pricking were manipulated through interspace lumbar nerves 2-3,three groups were diluted to 2ml with cerebrospinal fluid,the needle port toward the head,injection time of 8 seconds. Monitoring records in patients with circulatory function, sensory block level, motor block level and adverse reactions. Results: Sensory block plane and anesthesia of group RS was no significant difference between excellent and good rate compared with R10 group, the blood pressure was decreased and heart rate was slowed (Plt;0.01)of group R10 after treatment, but that of RS group change was not obvious, the Bromage score of RS group were higher than R10 group (Plt;0.01), degree of motor block was si