左旋布比卡因腰硬联合麻醉在剖宫产术中应用效果观察.docVIP

左旋布比卡因腰硬联合麻醉在剖宫产术中应用效果观察 　　[摘要] 目的 探讨左旋布比卡因腰-硬联合麻醉用于剖宫产的麻醉效果。方法 行剖宫产手术的100例患者随机分为LB组（左旋布比卡因）与B组（布比卡因组）各50例，监测并记录两组患者的收缩压、舒张压、心率在麻醉阻滞前后不同时间的变化情况、感觉阻滞时间及肌松情况。结果 ①两组麻醉阻滞5min后，LB、B两组的SBP、DBP、HR均分别较麻醉前下降（P＜0.05），但LB、B两组间阻滞前及麻醉阻滞后5、10、30min血压、HR变化差异均无统计学意义（P＞0.05）；②LB组麻醉阻滞起效时间显著晚于B组（P＜0.05），LB组胸椎最高阻滞平面低于B组（P＜0.05），两组新生儿Apgar评分在0、1、5min各时间段评分，差异无统计学意义（P＞0.05），LB组的麻醉效果优良率100%，与B组比较差异无统计学意义（P＞0.05）。结论 左旋布比卡因腰-硬联合麻醉在剖宫产术中的麻醉效果好，对血流动力学影响小、肌松效果好、麻醉起效快，可以广泛应用于剖宫产术。 　　[关键词] 左旋布比卡因；腰-硬联合麻醉；剖宫产 　　[中图分类号] R614.4[文献标识码] B [文章编号] 1673-9701（2011）21-119-02 　　 　　Levobupivacaine Spinal - epidural Anesthesia in Cesarean Section 　　CAI Lixiang 　　Department of Anesthesiology，Longyou County People’s Hospital in Zhejiang province，Longyou 324400，China 　　 　　[Abstract] Objective To observe the effect of levobupivacaine spinal-epidural anesthesia for cesarean section anesthesia. Methods 100 cases of cesarean section surgery were randomly divided into LB group （levobupivacaine） and B（bupivacaine group）. Results ①After 5min anesthesia，LB，B groups of the SBP，DBP，HR were decreased respectively as compared with before anesthesia（P＜0.05），but the LB，B groups before and after block anesthesia 5，10，30min BP，HR changes were not significantly different（P＞0.05）. ②The onset time of anesthesia of LB group was significantly later than the B group（P＜0.05），LB group the highest thoracic block level lower than the B group（P＜0.05）. Newborn infants Apgar score in 0，1，5min was not statistically significant（P＞0.05），two degree of muscle relaxation under anesthesia to determine which effect of LB group，good rate of 100% anesthesia，compared with B group，the difference was not significant（P＞0.05）. Conclusion Levobupivacaine spinal - epidural anesthesia in cesarean section anesthesia effect，little effect on hemodynamics，muscle relaxation effect，rapid onset of anesthesia，can be widely used to promote anesthesia for cesarean section. 　　[Key words] Levobupivacaine；Spinal - epidural anesthesia；Cesarean section 　　 　　剖