| 引用本文: | 张望平,任铭,常向阳,张引法,王立中.硫酸镁静脉给药对子痫前期产妇布比卡因腰麻时效的影响[J].中国现代应用药学,2016,33(3):348-352. |
| ZHANG Wangping,REN Ming,CHANG Xiangyang,ZHANG Yinfa,WANG Lizhong.Effect of Intravenous Magnesium Sulfate on the Time-effect of Intrathecal Bupivacaine in Preeclampsia Women[J].Chin J Mod Appl Pharm(中国现代应用药学),2016,33(3):348-352. |
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| 摘要: |
| 目的 研究静脉注射硫酸镁对子痫前期产妇布比卡因腰麻时效的影响。方法 选择60例择期行剖宫产术的子痫前期产妇，随机分为观察组(静脉硫酸镁组)和对照组，每组30例，观察组缓慢静脉注射硫酸镁0.05 g·kg-1(20 mL)，对照组静脉注射0.9%生理盐水20 mL，15 min后经L3~4间隙行腰硬联合穿刺成功后，向蛛网膜下腔注入0.5%重比重布比卡因7.5 mg+芬太尼25 μg。观察感觉阻滞起效和维持时间、运动阻滞的起效时间和恢复时间、麻醉维持时间，记录开始静脉注射硫酸镁(t0)、给药15 min后(t1)、切皮(t2)、胎儿娩出时(t3)及手术结束时(t4)的血流动力学参数及产妇并发症。新生儿行Apgar评分及脐动脉血气分析。结果 与对照组相比，观察组感觉阻滞起效时间缩短，感觉阻滞维持、运动阻滞恢复以及麻醉维持时间延长，有统计学差异(P<0.05)，但运动阻滞起效时间无统计学差异。2组产妇并发症、新生儿Apgar评分、血气无明显差异。与对照组相比，观察组术后镇痛药的需求量显著降低(P<0.05)。结论 硫酸镁静脉给药能加快感觉阻滞起效时间，延长感觉阻滞维持时间和运动阻滞恢复时间，延长布比卡因麻醉时间，但不能加快运动神经起效时间，不增加其不良反应。 |
| 关键词: 硫酸镁 剖宫产术 腰麻 量效关系 |
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| Effect of Intravenous Magnesium Sulfate on the Time-effect of Intrathecal Bupivacaine in Preeclampsia Women |
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ZHANG Wangping, REN Ming, CHANG Xiangyang, ZHANG Yinfa, WANG Lizhong
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Department of Anesthesiology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing 314051, China
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| Abstract: |
| OBJECTIVE To determine the effect of intravenous magnesium sulphate (MgSO4) to bupivacaine-fentanly spinal anesthesia in preeclampsia women undergoing caesarean section. METHODS Sixty women undergoing elective caesarean section were randomly divided into observation group (MgSO4 group) and the control group. The patients received spinal anesthesia with 7.5 mg hyperbaric bupivacaine and 25 μg fentanyl 15 min after either 20 mL of 0.9% sodium chloride (control group) or 20 mL of 0.05 g·kg-1 intravenous MgSO4 (observation group). Combined spinal epidural anesthesia was administered using a standardized technique. The onset and duration of sensory and motor block, duration of spinal anesthesia and postoperative analgesic requirements were studied. Hemodynamic parameters and side effects were recorded, and umbilical arterial blood gases were analyzed and Apgar’s score of neonate were done in both groups. RESULTS The onset of sensory was significantly shorter, and the duration of sensory block, motor block and spinal anesthesia was significantly longer in observation group(P<0.05). yet the onset of motor block was not significantly shorter in observation group. The requirement of postoperative analgesics was significant lower in observation group(P<0.05). Hemodynamic parameters and side effects were similar in both groups. CONCLUSION Intravenous MgSO4 could fasten the onset of sensory, prolong the duration of sensory block, motor block and spinal anesthesia, reduce the consumption of postoperative anesthetics, but not quicken the onset of motor block on bupivacaine-fentanyl spinal anesthesia in preeclampsia women without additional side effects. |
| Key words: magnesium sulfate cesarean section spinal anesthesia dose-response |
