包菊, 曲元

　　北大医院麻醉科100034

目的观察0.5%等比重罗哌卡因腰麻在剖宫产手术中的麻醉效果及并发症。

方法选择100例ASAⅠ-Ⅱ拟行剖宫产手术产妇，均采用腰麻-硬膜外联合麻醉（CSEA）方法。随机分为两组，分别向蛛网膜下腔注射0.5%（比重1.008）布比卡因和罗哌卡因。布比卡因组给予7mg～10mg，罗哌卡因组给予11mg～15mg。腰麻平面不足T6者，硬膜外腔追加2%利多卡因。

结果两组均于蛛网膜下腔注药后20min左右达到最高平面，均为T4（T6～T2）。运动阻滞分级在注药60min时出现显著性差异（P﹤0.05）,罗哌卡因组运动阻滞均可在150min内恢复。

结论0.5%罗哌卡因可以达到与0.5%布比卡因同样的阻滞麻醉效果，产生相对较少的麻醉并发症及更轻程度的运动阻滞。0.5%罗哌卡因可以作为布比卡因的替代药物。

Using of intrathecal isobaric ropivacaine for Caesarean section

BACKGROUNDThe purpose of our study was to evaluate the clinical efficacy and safety of intrathecal with 0.5% isobaric ropivacaine(1.008), compared with 0.5% isobaric bupivacaine(1.008) administered during combined spinal-epidural anesthesia for cesarean delivery and to elucidate the dose that produces adequate sensory blockade for surgery.

METHODSOne hundred parturients presenting for cesarean delivery were randomly assigned to one of the 2 groups. Group B received intrathecal isobaric bupivacaine 7mg～10 mg, Group R received intrathecal isobaric ropivacaine 11mg～15mg. Patients were monitored for sensory and motor blockages and side effects.

RESULTS0.5% isobaric ropivacaine, compared with 0.5% isobaric bupivacaine, produced spinal anesthesia of similar and effective clinical quality with shorter duration of motor block. However, the time to complete recovery from motor block was longer in the Group B than the Group R(P﹤0.001).Apgar scores at 1min and 5 min were similar in the two groups. With regard to side-effects, the incidence of nausea and vomiting was higher in the Group B than the Group R(P﹤0.05).

CONCLUSIONThis study suggests intrathecal with 0.5% isobaric ropivacaine provides sufficient anaesthesia for caesarean delivery. The 0.5% isobaric ropivacaine resulted in shorter motor block and similar postoperative analgesia.

　　关键词 麻醉/产科；麻醉/脊髓；罗哌卡因

更多精彩内容，请点击专题报道>>