右美托咪定复合罗哌卡因腰麻-硬膜外麻醉用于剖宫产术的效果分析-论文.pdf

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1、中国临床医学2014年4月第21卷第2期ChineseJournalofClinicalMedicine，2014．Vo1．21，No．2173论著右美托咪定复合罗哌卡因腰麻一硬膜外麻醉用于剖宫产术的效果分析张乐黄绍强(复旦大学附属妇产科医院麻醉科，上海200011)摘要目的：观察右关托咪定静脉给药应用于罗哌卡因腰麻一硬膜外麻醉下行剖宫产术的效果。方法：将择期行剖宫产手术、美国麻醉师协会(ASA)I或II级的136例产妇随机分为右美托咪定复合罗哌卡因组(Dex组)和罗哌卡因组(Rop组)，每组68例。Dex组蛛网膜下腔给予0．75罗哌卡因12mg并静脉注射负荷3,1量

2、0．2~g／kg、维持剂量0．5g／(kg·h)的右美托咪定至手术结束；Rop组蛛网膜下腔给予0．75罗哌卡因12mg并持续静脉注射与Dex组右美托咪定等量的0．9氯化钠液至手术结束。观察两组麻醉效果、对新生儿的影响及不良反应率。结果：Dex组麻醉起效时间、达到完全运动阻滞时间、BIS分值及Ramsay改良评分均明显短于Rop组(P0．05)。Dex组产妇寒战和焦虑的发生率均明显低于Rop组，而其

3、他不良反应差异无统计学意义。结论：右关托咪定静脉注射联合罗哌卡因腰麻-属E膜外麻醉可明显缩短麻醉起效时间、延长麻醉时间，具有更好的镇静效果。关键词右美托咪定；罗哌卡因；剖宫产中图分类号R414．4文献标识码AEffectsofDexmedetomidineonRopivacaineCombinedSpinal··EpiduralAnesthesiainPatientsReceivingCesar-eanSectionZHANGLeHUANGShaoqiangDepartmentofA札esthesioOg，ObstericalandGyneco—logicalHosp

4、ital，FudanUniversity，Shanghai200011，ChinaAbstraetObjective：Toinvestigatetheefficacyofdexmedetomidineintravenouslywithropivacainecombinedspinal—epiduralanesthesiainpatientsreceivingcesareansection．Methods：Atotalof136AmericanSocietyofAnesthesio10gists(ASA)I-IIpar—turientsplannedtOreceivec

5、esareansectionwereenrolledandrandomlydevidedintoDexgroupandtheRopgroup，with68ca—sesineachgroup．Allparturientshadcombinedspinal-epiduralanesthesiawith12mLofO．75ropivacaine．InDexgroup，parturientswereadministeredintravenouslydexmedetomidineataloaddoseof0．2tzg／kgandamaintenancedoseof0．5#g／(

6、kg·h)duringtheoperation．WhileparturientsintheRopgroupwereadministeredinfusionouslynormalsalineatthesamedoseandduration．Theanesthesiaefficiency，effectsonneonatesandtheadverseeffectsinthetWOgroupswereobserved．Results：ComparedwiththeRopgroup，theonsettimeofspinalanesthesia，timetOachievecomp

7、letemotorblock．TheBispectralindex(BIS)valueandtheRamsayScorewasstatisticallyshorterinDexGroup(P<0．05)．However，therecoverytimewassignifi—cantlylongerthanthatinRopgroup(P<0．05)．NostatisticallysignificantdifferenceswerefoundintheApgarscoresat1min．5minand10minbetweenDexgroupandRopg