剖宫产术布比卡因扩散与脑脊液生化特性的关系

目的探讨剖宫产术脑脊液生化特性与等比重布比卡因扩散的关系。方法腰麻的一次剂量为布比卡因与脑脊液之比15 mg:3 mL稀释混合而成药液,剖宫产腰麻剂量为10 mg/3 mL。比较分析100例剖宫产妇女与58例非妊娠妇女、61例男性与58例非妊娠妇女、22例绝经妇女与36例未绝经妇女(在58例非妊娠妇女组内)中的脑脊液生化5项与最大麻醉水平。结果男性患者脑脊液氯、总蛋白等指标与女性有明显差异(P<0.05)。剖宫产组的年龄以及脑脊液渗透压、总蛋白、钠等4项指标显著低于非妊娠妇女组,而最大麻醉水平显著高于非妊娠妇女组(P<0.01),其中脑脊液渗透压差异最明显。绝经妇女组与未绝经妇女组相比较除年龄外,各指标差异均无统计学意义。结论布比卡因腰麻剖宫产术100例的调查可见脑脊液渗透压与脊髓阻滞程度(麻醉水平)有相关关系。

The relationship between biochemical characteristics and bupivacaine drug spread in CSF for Caesarean section

Objective To investigate the relationship between biochemical characteristics and isobaric bupivacaine drug spread for Caesarean section in cerebrospinal fluid(CSF).Methods A total dose of 3 mL isobaric admixture of cerebrospinal fluid and 15 mg bupivacaine(Caesarean section 10 mg bupivacaine) in lumbar anesthesia were administered.The comparisons of cerebrospinal fluid osmotic pressure et al five item index and the extent of spinal block of Bupivacaine in 100 cases of Cesarean delivery and 58 cases of non-pregnant female,61 cases of male and 58 cases of non-pregnant female,22 cases of menopausal female and 36 cases of premenopausal female have been conducted.Results Cerebrospinal fluid chlorine,total proteins concentrations were significantly different in male patient than female(P<0.05).Cerebrospinal fluid osmotic pressure,total proteins, sodium concentrations,and age on spinal anaesthesia were significantly lower,but the extent of spinal block was significantly higher in cesarean delivery than in women(P<0.001),it was manifested among the total difference of cerebrospinal fluid osmotic pressure(F = 37.466).There were no difference except age in all biochemical characteristics index between menopausal female and premenopausal female(P>0.05).Conclusion A correlation between cerebrospinal fluid osmotic pressure and the extent of spinal block with plain bupivacaine is found in 100 cesarean delivery patients (A=44.46 -0.13B,r = 0.339).