目的 研究左旋布比卡因行蛛网膜下隙阻滞麻醉在剖宫产手术中的临床麻醉效果、安全性及可行性.方法 收集择期剖宫产患者180例,随机分为观察组和对照组,每组各90例.于L2～3间隙行蛛网膜下腔阻滞麻醉,分别注射0.75％左旋布比卡因1ml(观察组)和0.75％布比卡因1ml(对照组),观察并记录术中血流动力学变化、感觉阻滞起效及持续时间、感觉阻滞范围、VAS评分、下肢运动阻滞起效及持续时间、Bromage评分、腹肌松弛程度、术中、术后不良反应及并发症等情况.结果 麻醉效果对照组优73例,良17例,观察组优74例,良16例,优良率均为100％;两组产妇给药后在血压和HR等方面均出现轻度下降；低血压发生率对照组为10.0％,观察组为6.7％；感觉阻滞起效及恢复时间、运动阻滞起效及恢复时间和达最高阻滞平面时间等方面差异比较均无统计学意义.结论 左旋布比卡因阻滞麻醉效果满意且对血流动力学干扰小,可以安全、有效地应用于蛛网膜下腔阻滞麻醉.%Objective To investigate the clinical effect of anesthesia, safety and feasibility of L-bupivacaine through subarachnoid block in caesarean delivery. Methods 180 patients with cesarean section were collected and randomly divided into the study group (90 cases) and the control group (90 cases), which were injected with 0.75% le-vobupivacaine (1 ml) and 0.75% bupivacaine (1 ml) on L2～3 space on the line spinal anesthesia, respectively. The hemo-dynamic changes, sensory block onset and duration, sensory block extent, VAS score, lower limb motor block onset and duration, Bromage score, degree of abdominal muscle relaxation, postoperative adverse reactions and complica-tions were observed and recorded. Results The clinical effect of anesthesia was excellent in 73 cases and good in 17 cases in the control group, which was excellent in 74 cases and good in 16 cases in the study group. The excellent & good rate was 100% in the two groups. The maternal blood pressure and HR after administration in the two groups showed mild decline. The incidence of hypotension was 10% in the control group and 6.7% in the study group. The sensory block onset and recovery time, motor block onset and recovery time and the maximum blocking time showed no statistically significant difference between the two groups. Conclusion The anesthetic effect of levobupivacaine is satisfactory with few hemodynamic interferences, which is effective and safe for subarachnoid block.
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