罗哌卡因用于剖宫产术后产妇短暂性神经综合征的观察  

Observation on the effect of ropivacaine on transient neurologic syndrome of women after cesarean section

作　　者：于志刚[1] 

机构地区：[1]吉林大学第一医院麻醉科,吉林长春130021

出　　处：《中国妇幼保健》2009年第25期3600-3601,共2页Maternal and Child Health Care of China

摘　　要：目的:应用轻、中、重三种比重罗哌卡因对产妇行腰麻-硬膜外联合麻醉(combined spinalepidural anesthesia,CSEA),观察评估术后产妇神经功能。方法:120例急诊产妇CSEA下行剖宫产手术,随机分为三组,A组(40例)为重比重组,药液配方为0.75%罗哌卡因2ml+10%葡萄糖1ml,穿刺成功后注入1.2ml重比重液;B组(40例)蛛网膜下腔注入等比重液,配方为0.75%罗哌卡因2ml用脑脊液稀释至3ml,注入1.2ml;C组(40例)为轻比重组,配方为0.75%罗哌卡因2ml加入生理盐水1ml,注入1.2ml。注药速度均为30～40s。腰麻成功后向头侧置入硬膜外导管,留置4cm,如腰麻效果不良,经硬膜外腔注入2%利多卡因。观察术中及术后三天产妇下肢感觉及运动神经功能情况。结果:轻比重组术后感觉运动恢复最快,但阻滞不全发生率最高(P<0.05)。重比重组可逆性神经症状发生率高于其他两组(P<0.05)。结论:罗哌卡因等比重液用于剖宫产手术麻醉对产妇神经功能影响较小。Objective ： To evaluate the neurological function of pregnant women undergoing cesarean section under combined spinal and epidural anesthesia （CSEA） by different specific gravities of ropivacaine. Methods： 120 cases undergoing cesarean section were divided into three groups randomly： Group A （n = 40） received 1.2 ml of 0. 75% hyperbaric gravity ropivacaine; Group B （n = 40） received 1.2 ml of 0. 75 % isotonic specific gravity ropivacaine; Group C （n = 40） received 1.2 ml hypobaric ropivacaine for spinal anesthesia; 2% lidocaine was supplemented via epidural catheter if necessary. The perioperative and postoperative neurological function of pregnant women were observed. Results ： The recovery time of sensory and motor function in Group C was the shortest, but the rate of Incomplete block was the highest （ P 〈 0. 05 ）, the incidence of reversible neurological symptoms in Group A was higher than those in the other groups （ P 〈 0. 05 ） . Conclusion ： Isotonic specific gravity ropivacaine has little effect on neurological function of women undergoing cesarean section.

关 键 词：罗哌卡因 腰硬联合麻醉 产妇 短暂性神经综合征 

分 类 号：R719.8[医药卫生—妇产科学]