左旋布比卡因腰-硬联合麻醉在剖宫产术中的应用效果观察

目的探讨左旋布比卡因腰-硬联合麻醉用于剖宫产的麻醉效果。方法行剖宫产手术的100例患者随机分为LB组（左旋布比卡因）与B组（布比卡因组）各50例，监测并记录两组患者的收缩压、舒张压、心率在麻醉阻滞前后不同时间的变化情况、感觉阻滞时间及肌松情况。结果①两组麻醉阻滞5rain后，LB、B两组的SBP、DBP、HR均分别较麻醉前下降（P〈0．05），但LB、B两组间阻滞前及麻醉阻滞后5、10、30min血压、HR变化差异均无统计学意义（P〉0．05）；②LB组麻醉阻滞起效时间显著晚于B组（P〈0．05），LB组胸椎最高阻滞平面低于B组（P〈0．05），两组新生儿Apgar评分在0、1、5min各时间段评分，差异无统计学意义（P〉0．05），LB组的麻醉效果优良率100％，与B组比较差异无统计学意义（P〉0．05）。结论左旋布比卡因腰-硬联合麻醉在剖宫产术中的麻醉效果好，对血流动力学影响小、肌松效果好、麻醉起效快，可以广泛应用于剖宫产术。

Levobupivacaine Spinal-epidural Anesthesia in Cesarean Section

Objective To observe the effect of levobupivacaine spinal-epidural anesthesia for cesarean section anesthesia. Methods 100 cases of cesarean section surgery were randomly divided into LB group （ levobupivacaine ） and B （ bupivaeaine group ）. Results （1） After 5min anesthesia, LB, B groups of the SBP, DBP, HR were decreased respectively as compared with before anesthesia （P 〈 0.05 ）, but the LB, B groups before and after block anesthesia 5,10,30min BP, HR changes were not significantly different （P 〉 0.05 ）. （2） The onset time of anesthesia of LB group was significantly later than the B group （ P 〈 0.05 ）, LB group the highest thoracic block level lower than the B group （ P 〈 0.05 ）. Newborn infants Apgar score in 0, 1, 5min was not statistically significant （ P 〉 0.05 ）, two degree of muscle relaxation under anesthesia to determine which effect of LB group, good rate of 100% anesthesia, compared with B group, the difference was not significant （P 〉 0.05 ）. Conclusion Levobupivacaine spinal - epidural anesthesia in cesarean section anesthesia effect, little effect on hemodynamics, muscle relaxation effect, rapid onset of anesthesia, can be widely used to promote anesthesia for cesarean section.