预混合与按序给予高压布皮瓦卡因和芬太尼用于剖腹产中脑下关节阻塞的比较研究:随机对照试验
Rahul Kalshan1, Ranju Gandhi1, Trisha Nidhi1
1Anaesthesia and Intensive Care, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, IND.
Cureus
|December 23, 2025
概括
脊柱麻醉药物 (布皮瓦卡因和芬太尼) 的连续使用,与预混合药物相比,提供更快的感觉阻断开始和更长的持续时间. 这种方法可以改善剖腹产患者的血液动力稳定性.
科学领域:
- 麻醉学 麻醉学
- 产科麻醉 产科麻醉 产科麻醉
- 区域麻醉地区麻醉
背景情况:
- 脊髓麻醉是剖腹产的标准.
- 将高压布皮瓦卡因与内芬太尼相结合,可以提高疗效.
- 药物管理顺序可能会影响区块动态和稳定性.
研究的目的:
- 为了比较顺序与预混合的宫内布皮瓦卡因和芬太尼在剖腹产时.
- 评估对感觉阻塞发作,持续时间和血液动力学稳定性的影响.
主要方法:
- 对180名分娩者进行前性随机受控研究.
- 组M:预混合布皮瓦卡因9毫克+芬太尼15毫克克.
- 组S:同一种药物的连续使用.
主要成果:
- S组的T5感觉水平比M组 (P=0.0001) 快得多.
- 在S组 (P=0.0001) 中,感觉阻断的持续时间更长.
- 在S组 (P=0.563) 中,低血压和非尼莱弗林的使用量有所减少.
结论:
- 连续施用改善了感觉阻断动力学和血液动力学稳定性.
- 这种技术在产科麻醉中是安全有效的.
- 新生儿结局在各组之间是可比的.
相关概念视频
Local Anesthetics: Clinical Application as Epidural Anesthesia
661
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
661
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
1.1K
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
1.1K
Local Anesthetics: Clinical Application as Spinal Anesthesia
1.3K
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
1.3K
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.8K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
1.8K
Depolarizing Blockers: Pharmocokinetics
547
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
547
Parenteral Anesthetics: Overview
540
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
540


