Comparison of the safety of different doses of bupivacaine combined with epidural anesthesia for delivery women undergoing cesarean operation / 中国基层医药

ABSTRACT

Objective To explore the safety of different doses of bupivacaine combined with epidural anes-thesia for delivery women undergoing cesarean operation.Methods A total of 120 cases of parturient women with cesarean section surgery were randomly divided into A,B,C three groups (40 cases in each group).A group was subarachnoidly given 0.5% levobupivacaine 1.5mL(7.5mg),B group was given 0.5% levobupivacaine 2.0mL (10.0mg),C group was given 0.5% levobupivacaine 2.5mL(12.5mg).The anesthesia effect in three groups was recorded.Results 5 min after anesthesia,the central venous pressure,heart rate,blood oxygen saturation in A group were (79.47 ±10.65)mmHg,(83.94 ±8.21)times/min,(98.16 ±1.17)%,which in B group were (76.38 ± 10.15)mmHg,(84.03 ±8.19)times/min,(98.48 ±1.06)%,which in C group were (66.28 ±18.49)mmHg, (76.38 ±5.68)times/min,(95.03 ±0.45)%.10 min after anesthesia,the central venous pressure,heart rate,blood oxygen saturation in A group were (83.54 ±10.03)mmHg,(84.03 ±8.34)times/min,(98.25 ±1.19)%,which in B group were (82.46 ±10.11 )mmHg,(83.95 ±8.24)times/min,(98.04 ±1.15 )%,which in C group were (69.06 ±17.03)mmHg,(74.19 ±5.48)times/min,(94.85 ±0.41 )%,the changes of heart function index in A group and B group had statistically significant differences compared with those in C group(F =5.165,6.487,7.125, 6.145,5.378,6.145,all P <0.05 ).In A group,excellent anesthesia in 9 cases,good in 17 cases,and poor in 14 cases;those in B group were 24 cases,13 cases,3 cases;those in C group were 28 cases,11 cases and 1 case.The anesthesia effect of B group and C group was significantly higher than A group(χ2 =4.887,P <0.05).In A group, hypotension occurred in 1 case,bradycardia in 2 cases,2 cases had nausea and vomiting,shortness of breath 0 case.In B group,hypotension occurred in 2 cases,2 cases of bradycardia,nausea and vomiting 3 cases,difficulty in breathing in 1 case.In C group,15 cases of hypotension,bradycardia in 11 cases,14 cases had nausea and vomiting,dyspnea in 7 cases.The incidence rate of adverse reactions of C group was higher than A group and B group(χ2 =4.168,5.122, 4.784,5.122,all P <0.05).Conclusion The anesthesia effects of levobupivacaine combined spinal and epidural anesthesia in cesarean section surgery is related with dosage,the greater the dosage,the anesthesia effect is stronger, but the circulation disturbance,the greater the use the share such as 10mg dose of levobupivacaine is more suitable, worthy of popularization and application in clinic.