罗哌卡因腰麻-硬膜外联合麻醉用于剖宫产手术的临床研究

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1、等效剂量罗哌卡因和布比卡因腰麻-硬膜外联合麻醉用于Misgave-Ladach-Method剖宫产术的临床研究邵兵邹冬玲李泉刘琴湘郭训张斌【摘要】目的探讨等效剂量罗哌卡因、布比卡因腰麻-硬膜外联合麻醉用于Misgave-Ladach-Method剖宫产术的临床效能及安全性。方法选择ASAⅠ~Ⅱ级足月妊娠初产妇80例，随机双盲法分为两组，每组各40例。罗哌卡因组（R组）：0.75％罗哌卡因2m1+10％葡萄糖液0.5m1；布比卡因组（B组）：0.75％布比卡因1.25m1+10％葡萄糖液1.25m1。术中麻醉效应不足时经硬膜外导管补充2％利多卡因。术中连续监测呼吸和循环

2、状况，评估麻醉效能，观察围手术期不良反应的发生和新生儿情况。结果两组麻醉效能、最高阻滞平面、新生儿Apgar评分及不良反应相似(P>0.05)，但R组起效慢，维持时间短(P<0.05)；下肢运动阻滞程度R组显著低于B组(P<0.05)。结论等效剂量的罗哌卡因和布比卡因腰麻-硬膜外联合麻醉用于剖宫产术安全有效，与布比广因相比，罗哌卡因对下肢运动阻滞弱且恢复迅速。【关键词】罗哌卡因；布比卡因；腰麻-硬膜外联合麻醉；剖宫产，Misgave-Ladach-MethodClinicalinvestigationoftheisoeffect-doseofropivacainean

3、dbupivacaineforcombinedspinal-epiduralanesthesiaforMisgave-Ladach-Methodofcaesareansection.SHAOBing,ZOUDongling,LIQuan,etal.DepartmentofAnesthesiology,ThePeople,sHospitalofQingyuanCity,TheFifthAffiliatedofMedicalCollegeofJinanUniversity，Qingyuan511500，China【Abstract】ObjectiveToinvestiga

4、tiontheefficacyandsafetyoftheisoeffect-doseofropivacaineandbupivacaineforcombinedspinal-epiduralanesthesia(CSEA)forMisgave-Ladach-Methodofcaesareansection.MethodsEightyprimiparae(ASAⅠ~Ⅱ)schedualedforelectiveMisgave-Ladach-Methodofcaesareansectionweredividedintotwogroupswith40caseseach.R

5、opivacainegroup(R)received2m1of0.75％ropivacainewith0.5m1of10％glucose；bupivacainegroup(B)received1.25m1of0.75％bupivacainewith1.25m1of10％glucose.Itmaybesupplementedwith2%lidocaineviaepiduralcatheterwhentheefficacyofspinalanaesthesiawaspoor.Bloodpressure,heartrateandspo2wereassessed.Sensor

6、yandmotorblock,abdominalwallrelaxation,apgarscoreoftheneonatesandsideeffectswererecorded.ResultsTherewasnosignificantdifferenceamongthetwogroupsintheefficacy,theheightofblock,apgarscoreoftheneonatesandsideeffects(p>0.05)，buttheonsettimewaslongeranddurationofblockshorterinropivacainegrou

7、p(p<0.05).Motorblockwasweakerwithropivacainethanthatwithbupivacaine(p<0.05).ConclusionTheisoeffect-doseofropivacaineandbupivacainewereeffectiveandsafeforCSEAforbothparturientandneonate.Therecoveryfrommotorblockisfasterwithropivacainethenthatwithbupivacaine.Appropriatedoseofropi