盐酸氢吗啡酮复合布比卡因在腰硬联合阻滞剖宫产术中的应用

发布时间：2018-01-04 08:26

本文关键词：盐酸氢吗啡酮复合布比卡因在腰硬联合阻滞剖宫产术中的应用　出处：《实用医学杂志》2016年03期 　论文类型：期刊论文

【摘要】：目的:观察布比卡因复合盐酸氢吗啡酮鞘内注射用于剖宫产术的麻醉与阻滞效应。方法:选择单胎足月经剖宫产结束妊娠初产妇60例,分为两组:布比卡因组(B组)和布比卡因-氢吗啡酮组(BH组),各30例。所有患者于L3-4间隙行腰硬联合穿刺,穿刺成功后分别给予0.75%的布比卡因1.2 m L和0.75%的布比卡因1.2 m L+100μg氢吗啡酮注射液,比较两组麻醉开始至手术开始时低血压的发生率,最高痛觉阻滞平面,需要调整阻滞平面的例数,硬膜外需要加药的例数,同时观察记录术中恶心呕吐、寒战及腹部牵拉不适等不良反应的发生情况。结果:BH组麻醉初始平面及手术开始切皮时最高痛觉阻滞平面均高于B组(P0.05),需要调整手术床平面的例数、硬膜外需要加药的例数及术中寒战的例数BH组明显少于B组(P0.05),术后瘙痒发生率BH组高于B组(P0.05)。结论 :布比卡因复合使用氢吗啡酮能够安全有效的用于剖宫产术,其阻滞起效时间快,镇痛时间长,寒战发生率低。
[Abstract]:Objective: to observe the anesthesia and block effect of bupivacaine combined with intrathecal injection of hydromorphine hydrochloride for cesarean section. The patients were divided into two groups: bupivacaine group (group B) and bupivacaine group (group B) and bupivacaine hydromorphine group (group BH) with 30 cases each. All patients underwent combined lumbar and epidural puncture in the L3-4 space. After successful puncture, 0.75% bupivacaine 1.2 mL and 0.75% bupivacaine 1.2 mL 100 渭 g hydromorphine injection were given respectively. The incidence of hypotension from the beginning of anesthesia to the beginning of surgery, the highest level of pain block, the number of cases needed to adjust the level of block and the number of cases of epidural need to add drugs were compared between the two groups, and the nausea and vomiting during operation were observed and recorded. Results the initial level of anesthesia and the highest level of pain block at the beginning of incision in group B were higher than those in group B (P 0.05). The number of cases needed to adjust the level of the operation bed, the number of cases with epidural administration and the number of shivering during operation in group BH were significantly less than those in group B (P 0.05). The incidence of pruritus in group BH was higher than that in group B (P 0.05). Conclusion: bupivacaine combined with hydromorphine can be used safely and effectively in cesarean section. The incidence of shivering is low.
【作者单位】：三峡大学第一临床医学院宜昌市中心人民医院麻醉科;三峡大学第三临床医学院葛洲坝中心医院麻醉科;
【分类号】：R614
【正文快照】： 腰硬联合麻醉起效快、麻醉药用量小、阻滞完善,对循环干扰相对较小,可行硬膜外术后镇痛,且麻醉时间不受限制, 是剖宫产术首选的麻醉方法[1]。在国内早有阿片类镇痛药(芬太尼与舒芬太尼)鞘内注射用于腰硬联合阻滞的相关报道,并且较传统局麻药镇痛效果好[2,8]。 RAUCH[3]报道了

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