重比重罗哌卡因腰麻-硬膜外联合阻滞在急诊剖宫产术中的应用.doc

重比重罗哌卡因腰麻-硬膜外联合阻滞在急诊剖宫产术中的应用
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【摘要】研究重比重罗哌卡因腰-硬联合阻滞在急诊宫产术中的麻醉有效性和安全性。方法选择ASA I-II级、单胎、足月产妇急诊行剖宫产患者60例,随机分成3组,每组20例。%罗哌卡因10mg(A组)、12mg(B组)、15mg(C组)加入3%***15mg+10%葡萄糖1ml配成重比重液。于L2~3间隙穿刺,蛛网膜下腔注入***,观察麻醉起效时间、麻醉持续时间、麻醉效果;新生儿Apgar 评分及麻醉并发症。结果三组患者麻醉起效时间、麻醉最高阻滞平面差异无显著性()。A组麻醉持续时间明显短于B组、C组,且三组麻醉效果有差异()。硬膜外追加2%利多卡因者A组(65%)高于B组(20%) 和C组(15%)差异有显著性()。三组麻醉后5min血压低于麻醉前(),C组明显低于A组()。其他各时间点血变化差异无显著性()。三组间各时间点心率、血氧饱和度及新生儿Apgar 评分差异无显著性。C组的恶心呕吐、胸闷气短发生率高于A组和 B组,差异有显著性()。结论 %罗哌卡因12㎎在急诊剖宫产术腰麻-硬膜外联合阻滞时的有效剂量。
【关键词】罗哌卡因布比卡因腰麻-硬膜外联和麻醉剖宫产
【Abstract】 Objective To study the clinical effect and safety of high-concentration ropivacaine bined spinal-epidural anesthesia used in emergency caesarean section. Methods Sixty ASA class I-II patients with single birth and planed to do emergency caesarean sections were randomly and equally divided into 3 groups. Group A, B and C were received 10mg, 12mg and 15mg of % bined with 3% ephedrine 15mg and 10% glucose 1ml respectively. The anaesthetic was injected into epidural administration after applied L2-3 interspace. The onset time, duration, anesthesia effect, newborn Apgar and plications were There was no significant difference in statistics among three groups in anesthesia onset time and block level (). The anesthesia duration of group A is l