0.5%布比卡因在妊高征剖宫产术腰麻硬膜外联合麻醉中的应用体会

目的观察0.5%布比卡因腰麻—硬膜外联合麻醉(CSEA)用于妊高征剖宫产手术的麻醉效果及其安全性。方法妊高征剖宫产手术患者30例,先行硬膜外穿刺,继以针内针实施腰麻,脑脊液流出,注入0.5%布比卡因1.0~2.0 mL后置入硬膜外导管。根据阻滞平面,经硬膜外腔注入2%利多卡因5~10 mL。阻滞平面上界控制在T8~T10。结果硬膜外和腰麻穿刺均成功。麻醉平面维持在T8~S5。术中部分患者出现血压下降、恶心、呕吐、抽搐等症状,应用麻黄碱、安定、硫贲妥钠,均得以控制。术后未出现头痛及其他并发症,镇痛效果满意,对新生儿影响小。结论0.5%布比卡因CSEA用于妊高征剖宫产手术,临床麻醉效果满意,安全可行。

Experience of 0.5% Bupivacaine in Combination Spiral and Epidural Anesthesia of Pregnancy-hypertension Syndrome U-D

Objective To discuss the anesthesia effect and it safety of 0.5% bupivacaine in CSEA of pregnancy hypertension syndrome(PHS) U-D.Methods 30 cases were performed with epidural anesthesia,then 0.5% bupivacaine of 1～2 mL was injected spinal and level was control at T8-T10.Results The CSEA was successful and anesthesia level was from T8 to S5.The symptoms in operation were controlled.There were no headache and complication with satisfied analgesia effect and less affection of neonate.Conclusion This method might gain the best anesthesia effect and safe in PHS U-D.