罗哌卡因等比重液与重比重液用于产妇剖宫产术的临床研究  

Clinical study of isobaric ropivacaine and hyperbaric solution on maternal cesarean section

作　　者：马聪 胡利荣[2] 

机构地区：[1]温岭市妇幼保健院妇产科,浙江317500 [2]浙江省立同德医院妇产科,浙江310012

出　　处：《中国生化药物杂志》2014年第5期138-140,143,共3页Chinese Journal of Biochemical Pharmaceutics

基　　金：医药卫生一般研究计划A类(2011BYA028)

摘　　要：目的观察罗哌卡因(ropivacaine,Rop)等比重液与重比重液对产妇剖宫产术的麻醉效果及对术后神经功能的影响。方法选取2011年1月~2013年12月期间温岭市妇幼保健院收治的500例行腰-硬联合麻醉(combined spinal-epidural anesthesia,CSEA)的剖宫产妇随机分为2组,A组(n=250)采用罗哌卡因重比重液(0.75%罗哌卡因2 mL用10%葡萄糖稀释至3 mL),B组(n=250)采用等比重液(0.75%罗哌卡因2 mL用脑脊液稀释至3 mL),穿刺成功后蛛网膜下腔注入1.2 mL,注药时间均为30~40 s。观察麻醉效果及术后3天神经功能情况。结果 2组感觉阻滞最高节段、运动阻滞分级、术后麻醉平面无显著差异;但A组平面固定时间、术后下肢感觉、运动恢复时间均长于B组(P<0.05);但下肢感觉异常的发生率高于B组(P<0.05)。结论罗哌卡因等比重液麻醉持续时间短于重比重液,但术后对神经功能影响较重比重液小。Objective To observe the anesthetic effect of sobaric ropivacaine solution and hyperbaric solution on maternal cesarean section and postoperative neurological function. Methods 500 cases undergoing cesarean section collected in Wenling maternal and Child Health Hospital from Jan2011 to Dec 2013 were divided into 2 groups. Group A(n = 250) was received 1. 2 mL 0. 75% hyperbaric ropivacaine solution; Group B(n = 250) was received 1. 2 mL 0. 75% isotonic ropivacaine solution; the anesthetic effect and neurological function 3 days after operation were observed and compared between two groups. Results There were no significant differences in sensory block hifhest segment,motor block grade,and anesthesia level after operation between two groups. The anesthesia level holding time,lower limbs sensory and recovery time of sensory in group A were longer than that in group B(P < 0. 05),the incidence of neurological symptoms of lower limbs in group A was higher than that in group B( P < 0. 05). Conclusion The anesthesia holding time of isotonic ropivacaine solution is shorter than hyperbaric solution,and has little effect on neurological function after cesarean section.

关 键 词：罗哌卡因 等比重液 重比重液 剖宫产 麻醉效果 神经功能 

分 类 号：R246.3[医药卫生—针灸推拿学]