【摘要】 目的比较3种局麻药蛛网膜下腔麻醉用于剖宫产的临床效果。方法足月妊娠孕产妇90例拟剖宫产手术,随机分成氯普鲁卡因(chloroprocaine,CP)、利多卡因(1idocaine,Li)、丁卡因(dicaine,Di)3组,每组30例。在腰2～3脊间隙行腰-硬联合穿刺麻醉,腰麻分别给予1.5%CP 30mg、2%Li 40mg和0.33%Di 6.6mg,然后硬膜外间隙置管留作备用。分别观察和记录患者麻醉情况。结果 CP、Li和Di 3组腰麻起效时间分别是(23.85±6.89)、(34.29±8.94)和(28.32±9.84)s(P<0.05)。切口无痛时间和下肢不能运动时间3组相似。取得最高平面(固定)时间CP、Li和Di分别是(8.14±1.16)、(8.74±2.22)和(11.12±1.70)min(P<0.05)。取得的最高阻滞点CP、Li和Di分别是胸4.05±1.26、4.29±1.27和3.45±2.22。麻醉完全消退时间CP、Li和Di 3组分别是(78.45±16.83)、(160.74±56.89)和(471.54±99.24)min(P<0.01)。3组腰麻效果均非常满意,无需硬膜外麻醉辅助。均未发现麻醉后神经系统并发症。新生儿Apgar评分均正常。结论 1.5%CP 30mg,2%Li40mg和0.33%Di 6.6mg腰麻均满足剖宫产手术要求,但CP麻醉时效更合适。更多还原

【Abstract】 Objective To compare the effects of chloroprocaine,lidocaine,dicaine for spinal anesthesia in cesarean section.Methods Ninety primiparaes with full - term pregnancy were divided randomly into group CP(chloroprocaine,n =30),Li(lidocain,n =30)and Di(dicaine,n =30),who were punctured from lumbar 2～3 spinal interspace,and injected 30 mg of 1.5%CP,40 mg of 2%Li or 6.6 mg of 0.33%Di within 20 s into subarachnoid space,respectively.Results The onset times of CP,Li and Di were(23.85±6.89)s,(34.29±8.94)s and(28.32±9.84)s(P <0.05).respectively.Times to get painless at incision and motorless in lower limbs were similar among the three groups.Times to get the highest level of block in CP,Li and Di were(8.14±1.16)min,(8.74±2.22)min and(11.12±1.70)min(P <0.05).respectively.Peaks of needle puncture pain sensory block in CP,Li and Di groups were thoracic 4.05±1.26,4.29±1.27 and 3.45±2.22,respectively.Times of spinal anesthesia complete disappearance were(78.45±16.83)min,(160.74±56.89)min and(471.54±99.24)min respectively(P <0.01).All cases in three groups had highly satisfactory spinal anesthesia for surgery,no need for epidural anesthesia.No systemic and spinal nerve toxic responses were found in each group. Apgar scores were normal in each group.Conclusion Spinal anesthesia using 30 mg of 1.5%CP,40 mg of 2%Li and 6.6 mg of 0.33%Di for cesarean section are effective,but CP is better in effect - duration.更多还原