不同剂量芬太尼和左旋布比卡因硬膜外阻滞用于剖宫产术

目的 比较不同剂量芬太尼和左旋布比卡因硬膜外麻醉对剖宫产产妇和胎儿的影响。方法60例产妇ASAI或Ⅱ级，22～34岁。随机分为三组，每组20例。Ⅰ组：0．75左旋布比卡因8ml＋生理盐水2ml（对照），Ⅱ组：0．75左旋布比卡因8rnl＋芬太尼50μg＋生理盐水至10ml和Ⅲ组：0．75左旋布比卡因8ml＋芬太尼75μg＋生理盐水至10ml（观察）。结果芬太尼两组分别能够增强硬膜外左旋布比卡因的镇痛效果，明显改善产妇术中不适反应和提高麻醉质量。对新生儿Apgar评分无明显影响。50μg和75μg芬太尼组镇痛效果无明显差异。结论50μg芬太尼可明显增强左旋布比卡因硬膜外麻醉效能，改善产妇术中不适和提高麻醉质量，75μg芬太尼未见明显优势。

Epidural anesthesia with different dosage of fentanyl and levobupivacaine for cesarean section

Objective The aim of this study was to evaluate the effectiveness of different dosage of fentanyl and levobupivacaine for cesarean section.Methods Sixty women undergone elective caesarean section under epidural auaesthesia were randomised into three groups to receive either 2 ml of saline or 50 or 75 micrograms of fentanyl in 2 ml volume added to 8 ml of 0.75% levobupivacaine.Results Both of fentanyl intensified the epidural anaesthesia and reduced patient discorofort during the operation.There was no difference between the groups in the condition of the neonates as assessed by the Apgar score.Conclusion The results suggest that 50 micrograms of fentanyl added to 0.75% levobupivacaine increases patient comfort and improves the quality of epidural anaesthesia for caesarean section,and that adding 75 micrograms does not give further advantage.