布比卡因复合微量芬太尼脊麻防治剖腹产牵拉反应的效果观察

目的观察布比卡因复合微量芬太尼脊麻防治剖腹产牵拉反应的效果。方法选择ASAⅠ～Ⅱ级、足月、初产及单胎而需行剖腹产术患者100例,随机分成2组,每组50例。两组患者的年龄、性别、体重、局麻药用量、麻醉方法均无显著性差异,均选用腰硬联合麻醉(Combined Srinal-epinal Anesthesia,CSEA)。A组:重比重0.5%布比卡因10 mg+芬太尼10μg。B组:重比重0.5%布比卡因10 mg。观察术中牵拉反应和生命体征并记录,进行统计学处理。结果两组间麻醉前、后相对应的MAP(平均动脉压)、HR(心率)、RR(呼吸频率)和SpO2(血氧饱和度)变化均无统计学意义(p>0.05),两组间新生儿Apgar评分无显著性差异(p>0.05),比较两组中的牵拉反应,A组明显优于B组,有统计学意义(p<0.05)。结论脊麻药中加入微量芬太尼脊麻对剖腹产牵拉反应有良好效果。

THE PREVENTION AND CURE EFFCIENCY OF SPINAL ANESTHESIA WITH BUPIVACAINE AND MICRO - FENTANYL AGAINST DRAGGING REACTION

Objective To study the prevention and cure effciency of spinal anesthesia with bupivacaine and micro -Fentanyl against dragging reaction. Methods 100 patients with full term, primiparity and single fetus, in ASA I - II ,undergoing abdominal delivery, were randomly allocated to 2 groups. There are no differences in age, sex, weight, dose of localise anesthesia and methods of anesthesia between these two groups. Both of groups used CSEA （combined spinal - epidural anesthesia）. Group A： received 0.5% hyperbaric Bupivacaine l0 mg and 10 I~g fentanyl. Group B： received 0. 5% hyperbaric Bupivaeaine 10 mg. The dragging reaction and body sign were observed and record during the operation. Results The change of MAP,HR,RR and SpO2 before and after the anesthesia are not significant different between the two groups （p 〉0. 05）, there is no difference in Apgar Grade between newborns in the two groups （p 〉 0.05 ）. Comparing the dragging reaction between the two groups, group A is much better then group B （p 〈 0. 05 ）. Conclusion Spinal anesthesia with Fentanyl against dragging reaction has good effect on prevention and treatment.