【摘要】 目的 评价剖宫产手术中应用左旋布比卡因复合小剂量芬太尼或舒芬太尼的麻醉效果。方法 选择60例行剖宫产术的单胎足月初产妇,ASA为I级,随机分为3组(n=20):s组:左旋布比卡因11.25 mg复合舒芬太尼2.5μg、F组:左旋布比卡因11.25 mg复合芬太尼25μg、c组:左旋布比卡因11.25 mg不复合其它药物,3组均用10%葡萄糖液配制成重比重液3 ml用于蛛网膜下腔阻滞。记录3组产妇术中血流动力学变化,感觉、运动阻滞情况,术中腹肌松弛度、牵拉反应程度,术中低血压、心动过缓、恶心、呕吐、寒战、瘙痒等不良反应及处理情况,术中追加利多卡因例数、新生儿出生后1 min和5 rain Apgar评分等。结果 3组初产妇术中血流动力学变化、运动阻滞Bromage评分、术中腹肌松弛度、新生儿Apgar评分、恶心、呕吐、寒战、呼吸抑制等不良反应及处理无差异(P>0.05)。与c组比较,s组和F组感觉阻滞时间缩短、低血压及处理减少、术中追加利多卡因例数减少、牵拉反应评分降低、瘙痒发生率增高(P<0.05)。结论 左旋布比卡因复合等效剂量舒芬太尼或芬太尼复合腰麻,可增强麻醉效果,减少追加局麻药用量,降低术中牵拉反应,增加产妇舒适度感觉等,麻醉效果优于单纯应用左旋布比卡因,适合于剖宫产手术。更多还原

【Abstract】 Objective To evaluate the anesthesia effect of levobupivacaine combined with equivalent dose of fentanyl or sufentanil for cesarean section.Methods 60 full- term primiparous parturients underwent cesarean section with ASA I were randomly divided into 3 groups(n =20):S group(levobupivacaine 11.25 mg,sufentanil 2.5 μg),F group(levobupivacaine 11.25 mg,fentanil 25 μg),C group(levobupivacaine 11.25 mg).All the groups were treated with hyperbaric solution 3 ml(prepared by 10%glucose solution) for subarachnoid block.Hemodynamic changes,sense,motor block,relaxation of abdominal muscle,pull reaction degree,adverse reactions such as hypotension,bradycardia,nausea,vomiting,shivering,pruritus and relevant treatment,supplemental lidocaine cases during operation,!min and 5 min Apgar score after birth were recorded.Results There were no differences in hemodynamic changes,Bromage score of motor block,relaxation of abdominal muscle,neonatal Apgar score,nausea,vomiting,shivering,respiratory depression and relevant treatment(P > 0.05).Sensory block time was shorter,cases with hypotension and supplemental lidocaine were fewer,pull reaction degree was lower and incidence of pruritus was higher in S and F group(P<0.05).Conclusion Levobupivacaine combined with equivalent dose of fentanyl or sufentanil for spinal anesthesia can enhance anesthetic effect,reduce supplemental local anesthetics amount and traction reaction,increase the comfort of parturient,anesthesia effect of which is better than levobupivacaine only.Therefore,it is suitable for caesarean section.更多还原