摘要
Abstract
Objective:To observe the application of bupivacaine with fentanyl for combined spinal-epidural anesthesia in maternal obesity. Method:Sixty patients(ASA Ⅰto Ⅱgrades),whose BMI was within range of 30 kg/m2 and 40 kg/m2,were randomly allocated into 3 groups according to rate of injection of Bupivacaine and composite Fentanyl:injection rate as 5 mg of Bupivacaine and 20μg of composite Fentanyl as Group A,injection rate as 6 mg of Bupivacaine and 20μg of composite Fentanyl as Group B and Group C as injection rate as 7 mg of Bupivacaine and 20μg of composite Fentanyl. The amount of sample with and time to the emerge of plane reached T6 and T2 after spinal anesthesia,abdominal muscle relaxation level,rate of the emerge of hypotension,nausea and emesis,and the injection rate of Methamphetamine during the operation period,plus arrhythmia,rate of APGAR after labor and external usage of Epidural of puerperal were recorded. Result:Group C had more occurrence rate than both Group A and Group B of nausea,emesis,hypotension and arrhythmia. At the same time,the usage of ephedrine were more than those of Group A and B,and the differences were statistically significant(P<0.05). But the T6 plane percentage of Group A were lower than those of Group B and C,and the differences were statistically significant(P<0.05). During the operation the occurrence rate of peritoneal pull feeling and abdominal muscle tension were higher than those of Group B and C as well,and the differences were statistically significant (P<0.05). Conclusion:By using 6 mg of Bupivacaine and 20μg of composite Fentanyl,it works more rapidly,blocks better and gives less negative effect to fetus. Also puerperal has less occurrence rate of hemodynamic change,anesthetic complication and adverse reaction. That effectively avoids stimulation of body caused by excessive volatility of blood pressure after anesthesia,especially the adverse effect on fetus caused by hypotension.关键词
肥胖产妇/腰硬联合阻滞麻醉/剖宫产手术/布比卡因/芬太尼Key words
Obesity puerperal patient/Combined spinal-epidural anesthesia/Caesarean operation/Bupivacaine/Fentanyl
