标题：左旋布比卡因用于蛛网膜下腔阻滞麻醉90例临床观察

      作者：浦鹏飞 1，阎位明 2
    (1.北海市中医院麻醉科，广西 北海 536000；
2.桂林市人民医院手术室，广西 桂林 541002)

      卷次： 2012年23卷6期

      【摘要】 目的 研究左旋布比卡因行蛛网膜下隙阻滞麻醉在剖宫产手术中的临床麻醉效果、安全性及可行
性。方法 收集择期剖宫产患者180例，随机分为观察组和对照组，每组各90例。于L2~3间隙行蛛网膜下腔阻滞
麻醉，分别注射0.75%左旋布比卡因1 ml (观察组)和0.75%布比卡因1 ml (对照组)，观察并记录术中血流动力学
变化、感觉阻滞起效及持续时间、感觉阻滞范围、VAS评分、下肢运动阻滞起效及持续时间、Bromage评分、腹肌松
弛程度、术中、术后不良反应及并发症等情况。结果 麻醉效果对照组优 73例，良 17例，观察组优 74例，良 16
例，优良率均为100%；两组产妇给药后在血压和HR等方面均出现轻度下降；低血压发生率对照组为10.0%，观察
组为6.7%；感觉阻滞起效及恢复时间、运动阻滞起效及恢复时间和达最高阻滞平面时间等方面差异比较均无统
计学意义。结论 左旋布比卡因阻滞麻醉效果满意且对血流动力学干扰小，可以安全、有效地应用于蛛网膜下
腔阻滞麻醉。

      【关键词】 蛛网膜下腔阻滞麻醉；左旋布比卡因；布比卡因

      【中图分类号】 R614.4 【文献标识码】 A 【文章编号】 1003—6350（2012）06—041—03<

br>Clinical study of L-bupivacaine for spinal anesthesia.
PU Peng-fei 1, YAN Wei-ming 2. 1. Department of Anesthesiol-
ogy, Traditional Chinese Medicine Hospital of Beihai City, Beihai 536000, Guangxi, CHINA; 2. Department of Operating
room, People's Hospital of Guilin City, Guilin 541002, Guangxi, CHINA

【Abstract】 Objective To investigate the clinical effect of anesthesia, safety and feasibility of L-bupivacaine
through subarachnoid block in caesarean delivery. Methods 180 patients with cesarean section were collected and
randomly divided into the study group (90 cases) and the control group (90 cases), which were injected with 0.75% le-
vobupivacaine (1 ml) and 0.75% bupivacaine (1 ml) on L2~3 space on the line spinal anesthesia, respectively. The hemo-
dynamic changes, sensory block onset and duration, sensory block extent, VAS score, lower limb motor block onset
and duration, Bromage score, degree of abdominal muscle relaxation, postoperative adverse reactions and complica-
tions were observed and recorded. Results The clinical effect of anesthesia was excellent in 73 cases and good in 17
cases in the control group, which was excellent in 74 cases and good in 16 cases in the study group. The excellent &
good rate was 100% in the two groups. The maternal blood pressure and HR after administration in the two groups
showed mild decline. The incidence of hypotension was 10% in the control group and 6.7% in the study group. The
sensory block onset and recovery time, motor block onset and recovery time and the maximum blocking time showed
no statistically significant difference between the two groups. Conclusion The anesthetic effect of levobupivacaine
is satisfactory with few hemodynamic interferences, which is effective and safe for subarachnoid block.

      【Key words】 Subarachnoid block; Levobupivacaine; Bupivacaine