罗哌卡因混合舒芬太尼用于剖宫产术等比重腰麻的适宜配伍  

Optimum compatibility of ropivacaine and sufentanil for isobaric spinal anesthesia in caesarean section

作　　者：张爱荣 王月新 朱爱 Zhang Airong;Wang Yuexin;Zhu Ai(Department of Anesthesiology, Cangzhou People′s Hospital, Cangzhou 061000, China)

机构地区：[1]沧州市人民医院麻醉科,061000

出　　处：《中华麻醉学杂志》2018年第10期1234-1237,共4页Chinese Journal of Anesthesiology

摘　　要：目的探讨罗哌卡因混合舒芬太尼用于剖宫产术等比重腰麻的适宜配伍。方法蛛网膜下腔阻滞麻醉下行择期剖宫产术的足月初产妇160例,ASA分级Ⅰ或Ⅱ级。按照随机数字表法分为4组(n=40),腰麻药配伍分别为1%罗哌卡因1.5ml(15mg)-生理盐水3.5ml(A组)、1%罗哌卡因1.2ml(12mg)-舒芬太尼0.5ml(5μg)-生理盐水3.3ml(B组)、1%罗哌卡因1ml(10mg)-舒芬太尼0.5ml(5μg)-生理盐水3.5ml(C组)和1%罗哌卡因0.8ml(8mg)-舒芬太尼0.5ml(5μg)-生理盐水3.7ml(D组)。向头侧注药,速率0.1ml/s。记录感觉阻滞平面、运动阻滞程度、腹肌紧张程度和牵拉反应程度,记录术中阿托品和麻黄碱的使用情况和新生儿Apgar评分。结果新生儿Apgar评分均在正常范围。A组、B组和C组最高阻滞平面相似,而高于D组。与B组、C组和D组相比,A组阻滞起效时间较长且阿托品和麻黄碱使用率升高(P<0.05)。A组、B组和C组术中疼痛、腹肌紧张及牵拉反应程度明显低于D组(P<0.05),而3组之间的差异无统计学意义(P>0.05),而D组硬膜外辅助局麻药使用率30%(12例)。运动恢复时间C组和D组短于A组和B组(P<0.05);腰麻效果持续时间B组和C组长于A组和D组(P<0.05),而B组、C组之间的差异无统计学意义(P>0.05)。结论1%罗哌卡因1ml(10mg)-舒芬太尼0.5ml(5μg)-生理盐水3.5ml可作为剖宫产术等比重腰麻的适宜配伍。Objective To investigate the optimum compatibility of ropivacaine and sufentanil for isobaric spinal anesthesia in caesarean section. Methods A total of 160 nulliparous parturients who were at full term with a singleton fetus, of American Society of Anesthesiology physical status Ⅰ or Ⅱ, scheduled for elective caesarean section under subarachnoid block, were divided into 4 groups (n=40 each) using a random number table method: 1% ropivacaine 1.5 ml (15 mg)-normal saline 3.5 ml group (group A), 1% ropivacaine 1.2 ml (12 mg)-sufentanil 0.5 ml (5 μg)-normal saline 3.3 ml group (group B), 1% ropivacaine 1 ml (10 mg)-sufentanil 0.5 ml (5 μg)-normal saline 3.5 ml group (group C), and 1% ropivacaine 0.8 ml (8 mg)-sufentanil 0.5 ml (5 μg)-normal saline 3.7 ml group (group D). Drugs were injected in cephalad direction at a rate of 0.1 ml/s.The upper spread of sensory block, degree of motor block, abdominal muscle tension, traction response, requirement for atropine and ephedrine and neonatal Apgar scores were recorded. Results Neonatal Apgar scores were all within the normal range.A, B and C groups had similar upper spread of sensory block which was higher than that in group D. The onset time of block was significantly prolonged, and the requirement for atropine and ephedrine was increased in group A as compared with B, C and D groups (P<0.05). The degree of intraoperative pain, abdominal muscle tension and traction response was significantly lower in A, B and C groups than in group D (P<0.05), however, there was no significant difference among A, B and C groups (P>0.05). The requirement for supplemented epidural local anesthetics was 30% (12 cases) in group D. The recovery time to ambulation was significantly shorter in C and D groups than in A and B groups(P<0.05). The duration of spinal anesthesia was significantly longer in B and C groups than in A and D groups(P<0.05), however, there was no significant difference between group B and group C(P>0.05). Conclusion One percent ropivacaine 1 ml (10 mg)-sufentanil 0.

关 键 词：酰胺类 舒芬太尼 麻醉 脊椎 剖宫产术 

分 类 号：R614[医药卫生—麻醉学]