Geng Guiqi, Li Wenhui, Huang Shaoqiang
Department of Anesthesiology, Obstetrics & Gynecology Hospital, Fudan University Shanghai, China.
Int J Clin Exp Med. 2014 May 15;7(5):1417-21. eCollection 2014.
To study the change of maternal pulmonary function when ropivacaine and bupivacaine were used in spinal anesthesia for cesarean section, 40 ASA physical status I and II parturient scheduled to undergo cesarean section were randomly divided into bupivacaine and ropivacaine groups. Bupivacaine 9 mg and ropivacaine 14 mg were intrathecal injected respectively. FVC, FEV1 and PEFR were measured with spirometry before anesthesia and 2 h after intrathecal injection. Anesthesia level, the degree of motor block and VAS were also recorded.
The final level of sensory blockade was not different between groups. Forced vital capacity was significantly decreased with bupivacaine (3.0 ± 0.4 L to 2.7 ± 0.3 L, P < 0.05) and ropivacaine (2.9 ± 0.4 L to 2.5 ± 0.4 L, P < 0.05) while there were no difference between two groups. Forced expiratory volume during the first second and Peak expiratory flow rate were not decreased in each group. The degree of motor block in group R was less than group B at 2 h after intrathecal injection.
Decreases in maternal pulmonary function tests were similar following spinal anaesthesia with bupivacaine or ropivacaine for cesarean section. The clinical maternal effects of these alterations appeared negligible.
为研究剖宫产脊麻时使用罗哌卡因和布比卡因对产妇肺功能的影响,将40例拟行剖宫产的ASA身体状况Ⅰ级和Ⅱ级产妇随机分为布比卡因组和罗哌卡因组。分别鞘内注射布比卡因9mg和罗哌卡因14mg。在麻醉前和鞘内注射后2小时用肺量计测量用力肺活量(FVC)、第1秒用力呼气量(FEV1)和呼气峰值流速(PEFR)。记录麻醉平面、运动阻滞程度和视觉模拟评分(VAS)。
两组感觉阻滞的最终平面无差异。布比卡因组(从3.0±0.4L降至2.7±0.3L,P<0.05)和罗哌卡因组(从2.9±0.4L降至2.5±0.4L,P<0.05)的用力肺活量均显著降低,但两组之间无差异。每组的第1秒用力呼气量和呼气峰值流速均未降低。鞘内注射后2小时,罗哌卡因组的运动阻滞程度低于布比卡因组。
剖宫产脊麻时使用布比卡因或罗哌卡因后,产妇肺功能测试的降低相似。这些改变对产妇的临床影响似乎可以忽略不计。