目的：比较等比重的0.5%布比卡因7.5、10、12.5 mg腰麻行剖宫产手术的临床效果。方法将2015年4月-2016年4月该院腰硬联合麻醉下行剖宫产手术的患者300例,随机分成3组,每组100例、ASAI~II级。于L3-4间隙穿刺成功后向蛛网膜下腔注入0.5%布比卡因A组7.5 mg、B组10 mg、C组12.5 mg,硬膜外腔置管备用。比较3组麻醉起效时间、麻醉效果、寒战反应发生率、恶心呕吐、血管活性药物的使用、术中血流动力学变化及新生儿Apgar评分情况。结果3组均取得良好的麻醉效果A组达到98%、B、C两组都达到99%,硬膜外补充用药后麻醉效果都达到手术要求,新生儿Apgar评分均满意,麻醉起效时间相当A组(5.6±1.6)min、B组(5.4±1.3)min、C组(5.2±1.0)min,但A组术中血流动力学更稳定(低血压发生率A组10%、B组32%、C组47%)、寒战(A组8%、B组16%、C组18%)及恶心(A组8%、B组19%、C组28%)、呕吐(A组4%、B组16%、C组25%)的发生率也低于B组和C组。结论0.5%布比卡因等比重液7.5 mg腰麻行剖宫产手术具有较好的麻醉效果和安全性。%Objective Comparison of the clinical effect of isobaric bupivacaine 0.5% 7.5 mg,10 mg,12.5 mg spinal anesthe-sia for caesarean operation. Methods In April 2015 to April 2016 our waist hard joint anesthesia downlink cesarean section surgery of 300 cases of patients,Randomly divided into 3 groups,100 cases in each group、ASA I to II.Puncture success in L3-4 clearance after injected into subarachnoid space than paid 0.5%bupivacaine , A group 7.5 mg, group B 10 mg, group C 12.5 mg,Epidural cavity catheter. Set aside.Compare three groups of anesthesia work time、Anesthesia effect、Chills reac-tion rates、Nausea and vomiting、The use of vasoactive drugs、Intraoperative hemodynamic change and neonatal Apgar score. Results Three groups has achieved good results,98% of group A, B, C in the two groups are up to 99%,Epidural drug anesthesia effect after all meet the operation requirements,Neonatal Apgar score were satisfied,Anesthesia work time(5.6 ± 1.6) min group A, group B(5.4 ± 1.3) min, group C(5.2 ± 1.0) min,But A group of intraoperative hemodynamic more stable (The incidence of hypotension in group A was 10%、group B 32%, group C 47%)、Chills (group A 8% and group B 16%, group C 18%)and the incidence of nausea (group A 8% and group B 19%, group C 28%)and emesis(group A4% and group B 16%, group C 25%) are lower than that of group B and group C.Conclusion With the anesthetic effect and safety of good 0.5%isobaric bupivacaine solution 7.5 mg spinal anesthesia for caesarean operation.
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