左旋布比卡因腰麻在剖宫产术中的临床应用

目的比较0．5％等比重左旋布比卡因与布比卡因腰麻用于剖宫产手术的麻醉效果。方法选择ASAI～Ⅱ级,拟在腰麻下行剖宫产手术病人60例,随机分为两组,即左旋布比卡因组（LB组）和布比卡因组（B组）.所有病人分别蛛网膜下腔注射0．5％等比重左旋布比卡因与布比卡因2ml,记录各组感觉和运动神经阻滞的起效时间和维持时间、新生儿1min和5min Apgar评分和麻醉并发症。结果LB组病人的感觉阻滞起效时间（14．1±1．6）min,要晚于B组（8．9±2．7）min（P〈0．05）,术中运动阻滞级别、新生儿LApgar评分以及术后感觉和运动消退时间两组比较差异无显著性（P〉0．05）。结论0．5％等比重左旋布比卡因腰麻用于剖宫产手术是安全有效的,并能达到较为完善的麻醉效果。     

妇产科手术失血性休克100例麻醉处理方法探讨

目的：对待不同程度的失血性休克病人，采取不同的麻醉方法。使病人能安全、无痛、舒适的度过危险期。麻醉方法：连硬６９例，气管插管静吸复合麻醉１０例，局麻＋强化辅助麻醉性镇痛药１５例。结果：经麻醉及手术抗休克成功病人９８例，病情过重死亡２例，无麻醉原因引起直接死亡。结论：对于妇产科失血性休克病人，根据病情，采取边扩容补充血容量，边麻醉手术实施救治，取得了满意的效果。     

1例麻醉意外的抢救及分析

1　病例资料女 ,32 y。因“左侧甲状腺瘤”在双侧颈丛 (左侧颈深丛 ,右侧颈浅丛 )阻滞下行左侧甲状腺瘤切除术 ,双侧共使用 1 %利多卡因 0 .2 5%布比卡因 1 4ml(不含肾上腺素 )。麻醉后 2 5min测试阻滞区域麻醉完善。患者生命体征平稳 ,无声音嘶哑现象。手术开始的同时 ,使用哌替啶 50 mg 氟哌啶 2 .5mg,稀释后 iv,约 2 min后监护仪显示血氧饱和度由 98逐渐降至 90 ,询问病人有何不适 ,病人摇头未作回答 ,鼻导管供氧。缺氧症状未缓解 ,继而意识消失 ,手术切口渗血变黑 ,考虑麻醉意外导致呼吸困难 ,即行气管插管 ,喉镜暴露时见声带松弛 ,呼…     

左旋布比卡因腰麻在剖宫产术中的临床应用

Objective To compare the anesthetic effect of 0.5% isobaric levobupivacaine versus levobupivacaine in cesarean section. Methods 60 ASA Ⅰ - Ⅱ patient undergoing caesarean section under spinal anesthesia were randomly assigned to receive injections of 0.5% isobaric levobupivacaine (LB group) or bupivacaine of 2ml (B group) into the subarachnoid space Time to onset and to maintenance for sensory and motor nerve blockade, 1 min- and 5 min- Apgar's scores for neonates, and complications of the anesthetics were noted. Results The time to onset for sensory blockade was delayed in LB group LB as compared with B group [(14.1 ± 1.6) min vs. (8.9 ± 2.7) min, P< 0.05]. There were no significances between the two groups in the degree of motor blockade, Apgar's scores, and postoperative time to disappearance of sensory and motor blockade (P> 0.05). Conclusions Spinal anesthesia with 0.5% isobaric levobupivacaine in caesarean section is safe and effective and achieves an ideal anesthetic effect.     

丙泊酚联合瑞芬太尼双通道靶控对妇科腔镜手术血流动力学的影响

目的评价丙泊酚联合瑞芬太尼双通道靶控输注用于妇科腹腔镜手术的血流动力性分析和探讨其可行性、安全性。方法择期行妇科腹腔镜手术病例100例,ASA I～Ⅱ级,随机分为丙泊酚联合瑞芬太尼靶控输注组(TCI组)和静吸复合全麻组(G组),每组50例。观察两组患者麻醉开始前10 min、气管插管后1 min、气腹后10 min和拔管时的MAP和HR,并记录术毕停药后患者呼之睁眼清醒时间、拔管时间.术后24 h随访恶心、呕吐、术中知晓及患者满意度。结果术中TCI组血流动力学比G组平稳,差异有显著性(p<0.05)。术后苏醒TCI组也优于G组(p<0.05)。而且术后发生恶心、呕吐的患者明显较G组减少(p<0.05)。结论与常规静吸复合全麻下行妇科腹腔镜手术比较,丙泊酚联合瑞芬太尼双通道靶控输注在围术期血流动力学更平稳.术毕清醒快,拔管早,不良反应更少。该方法能安全有效地用于妇科腹腔镜手术。     

下腹部手术吗啡硬膜外超前镇痛的临床研究

目的：探讨吗啡硬膜外超前镇痛在下腹部手术中的应用效果？方法：80例下腹部手术患者于硬膜外麻醉后分为两组,吗啡超前镇痛组（P组）40例,对照组（C组）40例,其中P组于切皮前10min经硬膜外腔注入局麻药5mL＋吗啡2mg,以施行吗啡超前镇痛;而C组仅注入局麻药5mL。观察术中术后镇痛时间、效果、镇痛药使用情况及并发症等。结果：P组的术中术后镇痛效果优于C组（P〈0、05）．P组术中加药间隔时间较C组明显延长（P〈0．01）,利多卡因用量P组明显低于C组,术后疼痛评分小于Ⅲ级,镇痛时间大于24h者。P组为78％。C组为23％,P组明显高于c组。结论：吗啡超前镇痛是下腹部手术中一种较好的镇痛方法     

左旋布比卡因腰麻在剖宫产术中的临床应用

Objective To compare the anesthetic effect of 0.5% isobaric levobupivacaine versus levobupivacaine in cesarean section. Methods 60 ASA Ⅰ - Ⅱ patient undergoing caesarean section under spinal anesthesia were randomly assigned to receive injections of 0.5% isobaric levobupivacaine (LB group) or bupivacaine of 2ml (B group) into the subarachnoid space Time to onset and to maintenance for sensory and motor nerve blockade, 1 min- and 5 min- Apgar's scores for neonates, and complications of the anesthetics were noted. Results The time to onset for sensory blockade was delayed in LB group LB as compared with B group [(14.1 ± 1.6) min vs. (8.9 ± 2.7) min, P< 0.05]. There were no significances between the two groups in the degree of motor blockade, Apgar's scores, and postoperative time to disappearance of sensory and motor blockade (P> 0.05). Conclusions Spinal anesthesia with 0.5% isobaric levobupivacaine in caesarean section is safe and effective and achieves an ideal anesthetic effect.