氯普鲁卡因、利多卡因、丁卡因剖宫产腰麻比较

目的：比较三种局麻药蛛网膜下腔麻醉用于剖宫产。方法：90例足月妊娠孕产妇拟剖宫产随机分成氯普鲁卡因（CP），利多卡因（Li）、丁卡因（Di）三组．每组30例。在腰2-3脊间隙做腰硬联合穿刺，腰麻分别给予CP30mg，Li40mg和Di7．7mg。然后硬膜外置管留作备用。分别观察和记录病人麻醉情况。结果：CP、Li和Di三组麻醉起效时间分别是23．85±6．89s、34．29±8．94s和28．32±9．84s。取得切口无痛、平面最高时间和下肢不能运动时间（min）以及取得的最高阻滞点三组均相似。麻醉完全消退时间CP、Li和Di三组分别是78．45±16．83min．160．74±56．89min和471．54±99．24min。三组腰麻效果均非常满意，未行硬膜外麻醉。CP组从麻醉中恢复最快。均未发现麻醉后神经并发症。新生儿评分均正常。结论：剖宫产用氯普鲁卡因腰麻相对合理。

The Comparison of the Chloroprocaine,Lidocaine, Dicaine for Spinal Anesthesia in Obstetrics

Objective： To compare the effects of chloroprocaine, lidocaine, dicaine for spinal anesthesia in obstetrics. Methods： 90 prirniparaes with full-term pregnancy were divided randomly into group CP （chloroprocaine, n=30）, Li （lidocain, n=30） and Di （dicaine, n=30）, were punctured from lumbar 2-3 spinal interspace, and injected 30mg of CP, 40 mg of Li or 7.7 mg of Di within 20s into subarachnoid space, respectively. Results： The onset times of CP, Li and Di were 23.85±6.89s, 34.29±8.94s and 28,32±9.84s, respectively. Times to get painless at incision, the highest level of block, motorless in lower limbs and peaks of sensory block were similar among the three groups. Times of spinal anesthesia complete disappearance were 78.45±16.83min, 160.74±56.89rain and 471.54±99.24min respectively, P 〈 0.01 statistically among the three groups. All cases in three groups had highly satisfactory spinal anesthesia for surgery, no need for epidural anesthesia, but it was the fastest in group CP recovery from anesthesia. We could not any observe systemic and spinal nerve toxic responses in each group. Apgar scores were normal in each group. Conclusion： Chloroprocaine for spinal anesthesia is better than lidocain or dicaine in obstetrics.