剖宫产时使用10毫克重比重布比卡因与5微克舒芬太尼联合进行脊髓阻滞。不同容量的研究。

Spinal block with 10 mg of hyperbaric bupivacaine associated with 5 microg of sufentanil for cesarean section. Study of different volumes.

作者信息

Braga Angélica de Fátima de Assunção, Frias José Aristeu Fachini, Braga Franklin Sarmento da Silva, Pinto Daniela Roncoletta da Silva

机构信息

Seção de Anestesia, CAISM, UNICAMP.

出版信息

Rev Bras Anestesiol. 2010 Mar-Apr;60(2):121-9, 69-73. doi: 10.1016/s0034-7094(10)70016-7.

DOI:10.1016/s0034-7094(10)70016-7

PMID:20485956

Abstract

BACKGROUND AND OBJECTIVES

Several factors affect the cephalad dispersion of the anesthetic solution in the subarachnoid space; among them, physiological changes of pregnancy and the dose and volume of the local anesthetics should be mentioned. The objective of this study was to assess the effectivity and side effects of different volumes of the subarachnoid administration of the association of hyperbaric bupivacaine and sufentanil in cesarean sections.

METHODS

Forty patients, ASA I and II, undergoing elective cesarean section under spinal block were divided in two groups, according to the volume of the anesthetic solution: Group I (4 mL) and Group II (3 mL). The association of hyperbaric bupivacaine (10 mg(2) mL) and sufentanil (5 microg-1 mL) was used in both groups. In Group I, 1 mL of NS was added to the solution to achieve the volume of 4 mL. The following parameters were evaluated: latency of the blockade; upper limit of the sensorial blockade; degree of motor blockade; time for regression of the motor blockade; total duration of analgesia; maternal side effects; and neonatal repercussions.

RESULTS

Latency, the upper limit of the sensorial blockade, and the degree and time for regression of the motor blockade were similar in both groups; duration of analgesia was greater in Group I than in Group II, which was statistically significant. The incidence of side effects was similar in both groups. Maternal cardiocirculatory changes and neonatal repercussions were not observed.

CONCLUSIONS

Four milliliter of anesthetic solution composed of hyperbaric bupivacaine, 10 mg, associated with 5 microg of sufentanil was more effective than 3 ml of the same solution, providing better intra-and postoperative analgesia without maternal-fetal repercussions.

摘要

背景与目的

多种因素会影响蛛网膜下腔麻醉药溶液向头侧扩散；其中，应提及妊娠的生理变化以及局部麻醉药的剂量和容量。本研究的目的是评估剖宫产术中不同容量的高压布比卡因与舒芬太尼联合蛛网膜下腔给药的有效性和副作用。

方法

40例ASA I级和II级择期剖宫产且行脊麻的患者，根据麻醉药溶液容量分为两组：I组（4 mL）和II组（3 mL）。两组均使用高压布比卡因（10 mg/2 mL）与舒芬太尼（5 μg/1 mL）联合。I组在溶液中加入1 mL生理盐水以使容量达到4 mL。评估以下参数：阻滞潜伏期；感觉阻滞上限；运动阻滞程度；运动阻滞消退时间；镇痛总时长；母体副作用；以及新生儿反应。