Oğün C O, Kirgiz E N, Duman A, Okesli S, Akyürek C
Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Selçuk University, Konya, Turkey.
Br J Anaesth. 2003 May;90(5):659-64. doi: 10.1093/bja/aeg123.
This study was designed to evaluate the effects of intrathecal isobaric bupivacaine 0.5% plus morphine and isobaric ropivacaine 0.5% plus morphine combinations in women undergoing Caesarean deliveries.
Twenty-five parturients received ropivacaine 15 mg and morphine 150 micro g (RM group) and twenty-five parturients received bupivacaine 15 mg and morphine 150 micro g (BM group) for spinal anaesthesia. Sensory and motor block, haemodynamics, postoperative analgesia, fetal outcomes, and side-effects were evaluated.
Intrathecal bupivacaine-morphine and ropivacaine-morphine provided effective sensory anaesthesia and motor block. Time to reach complete motor block was shorter and time to complete recovery from motor block was longer in the BM group than the RM group (P<0.05). The time to regression of two dermatomes and time for the block to recede to the S2 dermatome were similar in both groups (P>0.05). Time to first complaint of pain and the mean total consumption of tenoxicam were similar in both groups (P>0.05). APGAR scores at 1 and 5 min were similar in the two groups, as were mean umbilical blood pH values (P>0.05). Hypotension and pruritus were the most common side-effects in both groups during the operation.
Intrathecal isobaric ropivacaine 0.5% 15 mg plus morphine 150 micro g provides sufficient anaesthesia for Caesarean delivery. The ropivacaine-morphine combination resulted in shorter motor block, similar sensory and postoperative analgesia.
本研究旨在评估鞘内注射0.5%等比重布比卡因加吗啡和0.5%等比重罗哌卡因加吗啡的联合用药对剖宫产女性的影响。
25例产妇接受15mg罗哌卡因和150μg吗啡用于腰麻（RM组），25例产妇接受15mg布比卡因和150μg吗啡用于腰麻（BM组）。评估感觉和运动阻滞、血流动力学、术后镇痛、胎儿结局及副作用。
鞘内注射布比卡因-吗啡和罗哌卡因-吗啡均提供了有效的感觉麻醉和运动阻滞。BM组达到完全运动阻滞的时间比RM组短，而从运动阻滞完全恢复的时间比RM组长（P<0.05）。两组中两个皮节消退的时间和阻滞消退至S2皮节的时间相似（P>0.05）。两组首次主诉疼痛的时间和替诺昔康的平均总消耗量相似（P>0.05）。两组1分钟和5分钟时的阿氏评分以及平均脐血pH值相似（P>0.05）。低血压和瘙痒是两组手术期间最常见的副作用。
鞘内注射0.5% 15mg等比重罗哌卡因加150μg吗啡可为剖宫产提供足够的麻醉。罗哌卡因-吗啡联合用药导致运动阻滞时间较短，感觉和术后镇痛效果相似。
