小剂量等比重腰麻联合硬膜外麻醉用于剖宫产的麻醉效果

摘要

Objective To observe the effect of low dose isobaris 0.75% ropivacaine for combined spinal and epidural an-esthesia for cesarean section. Methods Thirty patients( ASAI-II) scheduled for cesarean section were divided into two groups, epidural combined spinal group (A group) received 0. 75% bupivacaine 1mL at subarach- noid space and 2% lidocaine 5mL at epidural space 2% lidocaine 5mL was boosted every 30minutes at epidural sp-ace. spinal group (B group) received 0. 75% bupi-vacaine 2mL. The sensory block were measured by pin puncture, the motor level were evaluated by modified Bromage scale meth-ods. The blockage effect and hypotension of pati-ents were recorded. Results Cephalad spread of sensory blockade in group A was lower than in group B(P<0.05), There was no significant difference in modified Bromage scale and blockage effect in be-tween two groups(P> 0.05). Hypotension in group A was lower than group B(P< 0.05 ). Conclusion The effect of low dose isobaris 0. 75% ropivacaine for combined spinal and epidural anesthesia for cesarean section can provide reliable anesthesia and has the minimal effect on maternal hemodynamics. There was a significant worth of clinical application.%目的：探讨小剂量等比重腰麻联合硬膜外麻醉的效果。方法选择年龄18~40岁单胎孕妇30例,随机分为小剂量等比重腰麻联合硬膜外组(A 组),等比重腰麻组(B 组),每组15例。 A 组蛛网膜下隙注入0.75%的布比卡因1.0mL,硬膜外注入2%的利多卡因5mL,并每半小时追加2%的利多卡因5mL。 B 组蛛网膜下隙注入0.75%的布比卡因2.0mL.用针刺法测定感觉平面。运动阻滞的程度用改良的 Bromage 评分法,对麻醉阻滞效果进行评分,观察低血压发生情况。结果 A 组痛觉阻滞平面低于 B 组,两组比较差异有统计学意义(P <0.05),两组改良 Bromage 评分无显著意义,两组间麻醉阻滞效果比较差异无统计学意义(P >0.05),A 组低血压发生率低于 B 组,差异有统计学意义(P <0.05)。结论小剂量等比重腰麻联合硬膜外麻醉用于剖宫产麻醉效果好,循环稳定,具有显著的临床应用价值。