小剂量等比重腰麻联合硬膜外麻醉用于剖宫产的麻醉效果

目的：探讨小剂量等比重腰麻联合硬膜外麻醉的效果。方法选择年龄18～40岁单胎孕妇30例,随机分为小剂量等比重腰麻联合硬膜外组（A 组）,等比重腰麻组（B 组）,每组15例。 A 组蛛网膜下隙注入0.75%的布比卡因1.0mL,硬膜外注入2%的利多卡因5mL,并每半小时追加2%的利多卡因5mL。 B 组蛛网膜下隙注入0.75%的布比卡因2.0mL.用针刺法测定感觉平面。运动阻滞的程度用改良的 Bromage 评分法,对麻醉阻滞效果进行评分,观察低血压发生情况。结果 A 组痛觉阻滞平面低于 B 组,两组比较差异有统计学意义（P 〈0.05）,两组改良 Bromage 评分无显著意义,两组间麻醉阻滞效果比较差异无统计学意义（P 〉0.05）,A 组低血压发生率低于 B 组,差异有统计学意义（P 〈0.05）。结论小剂量等比重腰麻联合硬膜外麻醉用于剖宫产麻醉效果好,循环稳定,具有显著的临床应用价值。

The Effect of Low Dose Isobaris 0 75% Ropivacaine for Combined Spinal and Epidural Anesthesia for Cesarean Section

Objective To observe the effect of low dose isobaris 0.75% ropivacaine for combined spinal and epidural anesthesia for cesarean section. Methods Thirty patients（ ASAI-II） scheduled for cesarean section were divided into two groups, epidural combined spinal group （A group） received 0. 75% bupivacaine 1mL at subarach-noid space and 2% lidocaine 5mL at epidural space 2% lidocaine 5mL was boosted every 30minutes at epidural space. spinal group （B group） received 0. 75% bupivacaine 2mL. The sensory block were measured by pin puncture, the motor level were evaluated by modified Bromage scale methods. The blockage effect and hypotension of patients were recorded. Results Cephalad spread of sensory blockade in group A was lower than in group B（P〈0.05）, There was no significant difference in modified Bromage scale and blockage effect in between two groups（P〉 0.05）. Hypotension in group A was lower than group B（P〈 0.05 ）. Conclusion The effect of low dose isobaris 0. 75% ropivacaine for combined spinal and epidural anesthesia for cesarean section can provide reliable anesthesia and has the minimal effect on maternal hemodynamics. There was a significant worth of clinical application.