等比重盐酸罗哌卡因腰麻用于剖宫产的临床研究  

Clinical study of spinal anesthesia using isobaric ropivacaine for cesarean section

作　　者：董龙禹[1] 吴明毅[1] 李江伟[1] 郭玉洁[1] 朱丽娜[1] 

机构地区：[1]武警山东总队医院麻醉科,济南250014

出　　处：《武警医学》2009年第7期609-611,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨等比重盐酸罗哌卡因腰麻用于择期剖宫产手术的安全性与有效性。方法200例ASAⅠ～Ⅱ级拟行择期剖宫产足月妊娠产妇,随机分为罗哌卡因组(R组)与布比卡因组(B组),每组100例。均于L_(3-4)间隙穿刺,腰麻给药量分别为:R组0.5%等比重盐酸罗哌卡因2.5 ml(12.5 mg),B组用等效剂量0.5%布比卡因1.6ml(8mg),观察胎儿娩出后评分、产妇血压、心率改变及运动神经阻滞时间。结果两组胎儿娩出评分正常,R组仰卧位低血压及心率减慢发生率显著降低,与B组比较差异有统计学意义(P<0.01)。两组感觉阻滞起效时间无差异,R组运动阻滞持续时间明显短于B组,差异有统计学意义(P<0.01)。结论等比重罗哌卡因腰麻对剖宫产产妇术中生理功能干扰小,运动神经阻滞时间短,仰卧位低血压综合征发生率低,可减少麻醉并发症发生机会,提高剖宫产手术麻醉安全性。Objective To evaluate the clinical efficacy and safety of spinal anesthesia with 0.5% ropivacaine for elective cesarean section. Methods Two hundred ASA Ⅰ or Ⅱ full - term parturient women were randomly divided into two groups： ropivacaine group（ group R） and bupivacaine group （group B）, 100 parturients each. Both groups were punctured at L3 -4 interspace. Group R was given isobaric 0.5% ropivacaine 2.5 ml and group B 0.5% bupivacaine 1.6 ml intrathecal injection. The blood pressure, heart rate, sensory and motor nerve block time, and Apgar scores were observed. Results The Apgar scores were not found different, and the on- set time for sensory block was similar in the two groups. The motor nerve block time in group R was significantly shorter, hypotension and bradycardia incidence rate were significantly reduced, with a very statistically significant differences between group R and group B （P 〈0. 01）. Conclusion Isobaric ropivacaine provides safe and effective spinal anesthesia with shorter duration of motor block and lower hypotension and bradycardia incidence rate, compared with bupivacaine when administered for cesarean section.

关 键 词：剖宫产 腰麻 罗哌卡因 布比卡因 

分 类 号：R614.41[医药卫生—麻醉学]