罗哌卡因腰-硬联合麻醉用于妊娠高血压综合征孕妇剖宫术  

The clinical study of ropivacaine for combined spinal epidural anesthesia undergoing cesarean delivery of pregnant woman with gestational hypertension

作　　者：王晓军[1] 施燕飞[1] 徐连生[1] 汤荣兴[1] 张努[1] 李雪刚[1] 

机构地区：[1]宜宾市第一人民医院麻醉科,四川宜宾644000

出　　处：《四川医学》2014年第1期46-48,共3页Sichuan Medical Journal

摘　　要：目的探讨罗哌卡因腰-硬联合麻醉用于妊娠高血压综合征孕妇剖宫术的有效性和安全性。方法选择60例ASA I^II级,孕≥36周、轻、中度妊高征患者,实施罗哌卡因腰-硬联合麻醉后,测定患者的感觉阻滞起效时间、感觉平面固定时间、运动阻滞起效时间、感觉阻滞消退时间、运动恢复时间及阻滞平面;观察术中有无恶心、呕吐、头晕、心律失常等不良反应;术后72h内麻醉并发症;监测麻醉前、麻醉后5、10、20、30min患者的收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏氧饱合度(SpO2);新生儿Apgar评分,记录手术时间。结果感觉阻滞起效时间:(2.1±0.73)min、感觉平面固定时间:(12±1.59)min、感觉阻滞消退时间:(83.42±17.16)min、运动阻滞起效时间:(9.4±2.10)min,运动恢复时间:(94.50±14.60)min;阻滞平面最高达T10;新生儿Apgar评分:(8.65±0.97)分;手术时间:(39.37±5.10)min;麻醉后5、10、20、30min的收缩压、舒张压、心率、血氧饱合度与麻醉前比较差异无统计学意义(P>0.05);术中无恶心、呕吐、心律失常等并发症发生;术后72h内随访,无头痛及神经系统并发症,新生儿母乳喂养安全。结论 0.3%甲磺酸罗哌卡因3ml(9mg)重比重腰麻药用于轻、中度妊娠高血压综合征孕妇剖宫术腰-硬联合麻醉,血流动力学稳定,无心脏及神经系统不良反应,新生儿安全。Objective To investigate the efficacy and security of ropivacaine for combined spinal epidural anesthesia （CSEA） undergoing cesarean delivery of pregnant woman with gestational hypertension. Methods After the implementation of ropivacaine for combined spinal epidural anesthesia, 60 ASA I to II of patients undergoing cesarean delivery of pregnant woman with stable mild gestational hypertension in sensory block onset time, feeling flat fixed time, motor block onset time, sensory block subsided time, sports recovery time and the block plane were measured; there were whether nausea, vomiting, dizziness, cardiac arrhythmia and other adverse reactions intraoperative; Within 72hours after anesthesia complications; Monitoring before anesthesia and after anesthesia 5min, lOmin, 20min and 30min respectively in patients with systolic blood pressure （SBP） , diastolic blood pressure （OBP） , heart rate （HR） and pulse oxygen saturation （Sp02） , as well as, Apgar scores of newborn and recording operative time. Results Sensory block onset time： （2. 1 ± 0.73） min, feel a fixed time plane： （ 12 ± 1. 59） min, sensory block subsided time： （83.42 ± 17. 16） min; motor block onset time： （9.4 ± 2. 10） min and sports recovery time： （94. 50 ± 14. 60） min; Apgar score ： （8. 65 ± 0.97） ; Operative time： （ 39. 37 ± 5. 10） min; there were no statistically significant difference （P 〉 0. 05） anesthesia 5 min andlOmin, 20 min and 30min of systolic blood pressure, diastolic blood pressure, heart rate and blood oxygen saturation as compared with before anesthesia; there were no intraoperative nausea, vomiting, arrhythmia and other complications, at the same time, no headache and neurological complications postoperative within 72 h followed-up. Conclusion Combined spinal epidural anesthesia （CSEA） with 0.3 percent ropivacaine mesylate injection of 3ml （9mg ） undergoing cesarean delivery of pregnant woman with stable mild gestational hypertension had satisfactory anest

关 键 词：罗哌卡因 腰-硬联合麻醉 妊娠高血压综合征 剖宫术 

分 类 号：R614[医药卫生—麻醉学]