腰硬联合麻醉剖宫产术中布比卡因剂量的临床进展

布比卡因腰硬联合麻醉(combined spinal-epidural anesthesia,CSEA)在剖宫产中的应用较多,但其腰麻用于剖宫产术的最佳剂量较难确定,通过阅读文献发现有4种方法分别为给予小剂量腰麻,把腰麻限制在低位节段,通过硬膜外追加利多卡因来加强麻醉效果;根据身高与体重调节腰麻的剂量;通过硬膜外注射盐水来减少腰麻剂量;通过布比卡因腰麻复合阿片类药物来减少腰麻剂量,可使母体血液动力学相对稳定,副作用发生率低,麻醉效果好,但在这4种给药方法中,究竟哪一种能使剖宫产患者血液动力学最稳定、麻醉效果最好、副作用最少,还有待于进一步研究.

Study on the dose of bupivacaine for combined spinal- epidural anesthesia in caesarean section

Although bupivacaine for combined spinal-epidural anesthesia (CSEA) in cesarean section is widely used ,its optimal dose in spinal anesthesia for cesarean section is still difficult to determine. There are four methods in the literature to make maternal hemodynamic parameters more stable and to lower incidence of side-effects while providing equally effective anesthesia.The four methods include a low dose spinal anesthesia combined with epidural anesthesia, an adjusted dose of local anaesthetic for spinal anaesthesia according to body height and weight, epidural volume extension (EVE) by an epidural injection of physiological saline solution and a low-dose local anesthetic-opioid spinal anesthesia. The most optimal one among the 4 methocls are still worthy of further study.