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不同剂量鞘内注射高压布比卡因联合舒芬太尼用于剖宫产脊髓麻醉的效果

The Effect of Different Doses of Intrathecal Hyperbaric Bupivacaine Plus Sufentanil in Spinal Anesthesia for Cesarean Sections.

作者信息

Alimian Mahzad, Mohseni Masood, Faiz Seyed Hamid Reza, Rajabi Alireza

机构信息

Associate Professor, Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran.

Resident, Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Anesth Pain Med. 2017 Dec 31;7(6):e14426. doi: 10.5812/aapm.14426. eCollection 2017 Dec.

Abstract

BACKGROUND

Decreasing side effects and improving the quality of block in caesarean sections by appropriate dosage of local anesthetics and adjuvants could play an important role in the safe management of cesarean section. The present study aimed at comparing the effects of 3 different doses of intrathecal hyperbaric bupivacaine injected with a fixed dose of sufentanil in cesarean sections.

METHODS

In a double- blind randomized clinical trial, 105 candidates of elective cesarean section were randomly assigned into 3 groups of 8, 9, and 10 mg of intrathecal bupivacaine plus sufentanil 2.5 µg. The maximum level of sensory block, the intensity of motor block, and vital signs were measured at regular intervals. The incidence of hypotension and bradycardia were also recorded.

RESULTS

No significant difference was found between the maximum level of sensory block and the intensity of motor block in 3 groups. The incidences of hypotension and bradycardia as well as administration of atropine and ephedrine were comparable among the 3 groups (P > 0.05).

CONCLUSIONS

According to similar effects of different doses of bupivacaine, administration of lower doses of bupivacaine (8mg) is more reasonable for spinal anesthesia for cesarean section.

摘要

背景

通过适当剂量的局部麻醉药和佐剂降低剖宫产术中的副作用并提高阻滞质量,对剖宫产的安全管理具有重要作用。本研究旨在比较剖宫产术中鞘内注射3种不同剂量的重比重布比卡因与固定剂量舒芬太尼的效果。

方法

在一项双盲随机临床试验中,105例择期剖宫产候选人被随机分为3组,分别鞘内注射8mg、9mg和10mg布比卡因加2.5μg舒芬太尼。定期测量感觉阻滞的最高平面、运动阻滞的强度和生命体征。记录低血压和心动过缓的发生率。

结果

3组之间感觉阻滞的最高平面和运动阻滞的强度无显著差异。3组之间低血压和心动过缓的发生率以及阿托品和麻黄碱的使用情况相当(P>0.05)。

结论

根据不同剂量布比卡因的相似效果,较低剂量(8mg)布比卡因用于剖宫产脊髓麻醉更为合理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef05/5903377/f349005a9567/aapm-07-06-14426-i001.jpg

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