0.5%罗哌卡因腰麻分次注药用于重度子痫前期剖宫产效果分析  

Effect Analysis of Fractionated Dose Injection of 0.5%Ropivacaine for Spinal Anesthesia in Cesarean Section of Severe Preeclampsia Patients

作　　者：何鹏[1] 张丽[1] 梁永涛[1] 周述芝[1] 冉鑫[2] He Peng;Zhang Li;Liang Yongtao;Zhou Shuzhi;Ran Xin(Department of Anesthesiology, Ya'an People's Hospital, Ya'an 625000,China;Department of Anesthesiology, North Sichuan Medical College, Nanchong 637000, China)

机构地区：[1]雅安市人民医院麻醉科,雅安625000 [2]川北医学院麻醉学系,南充637000

出　　处：《成都医学院学报》2021年第1期33-36,共4页Journal of Chengdu Medical College

基　　金：四川省卫生健康委员会基金项目(No:19PJ156)。

摘　　要：目的探讨0.5%罗哌卡因腰麻分次注药方式对重度子痫前期产妇剖宫产手术的麻醉效果及安全性。方法选取2018年12月至2020年1月雅安市人民医院在腰麻下进行剖宫产的重度子痫前期产妇68例,按随机数字表法分为对照组(n=34)和试验组(n=34)。腰麻穿刺成功后对照组一次推注0.5%罗哌卡因2.5 mL;试验组首先推注0.5%罗哌卡因1.5 mL,60 s后再推注余下的1 mL。比较两组患者麻醉效果及安全性。结果两组患者的感觉神经阻滞起效时间、达峰时间、痛觉阻滞平面、运动神经阻滞起效时间差异无统计学意义(P>0.05);与入室时比较,注药后的平均动脉压(mean arterial pressure,MAP)明显降低,差异有统计学意义(P<0.05)。注药后3 min时,试验组患者MAP高于对照组,差异有统计学意义(P<0.05)。试验组低血压发生率低于对照组,差异有统计学意义(P<0.05)。两组患者恶心呕吐、新生儿Apgar评分及去氧肾上腺素使用量差异无统计学意义(P>0.05)。结论采用0.5%罗哌卡因分次注药进行腰麻用于重度子痫前期产妇剖宫产术,不影响麻醉效果,且血流动力学更稳定。Objective To investigate the anesthetic effect and safety of fractionated dose injection of 0.5%ropivacaine for spinal anesthesia in caesarean section for women with severe preeclampsia.Methods A total of 68 cases of severe preeclampsia patients underwent cesarean section surgery with spinal anesthesia in Ya'an People's Hospital from December 2018 to January 2020 were selected and divided into control group(n=34)and experimental group(n=34)according to random number table method.After successful spinal puncture,the control group was injected with 0.5%ropivacaine 2.5 mL at one time,while the experimental group was first injected with 0.5%ropivacaine 1.5 mL,and the remaining 1 mL was injected after 60 seconds.The anesthetic effect and safety of the two groups were compared.Results There was no statistically significant difference between the two groups in sensory block onset time,sensory block peak time,pain block plane and motor block onset time(P>0.05).Compared with when entering the operating room,the mean arterial pressure(MAP)after injection decreased significantly,and the difference was statistically significant(P<0.05).At 3 min after injection,the MAP in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).The incidence of hypotension in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).There were no significant difference in the incidence of post operative nausea and vomitting,Apgar Score and dosage of norepinephrine between the two groups(P>0.05).Conclusion The application of fractionated dose injection of 0.5%ropivacaine for spinal anesthesia in caesarean section of women with severe preeclampsia does not affect the anesthetic effect,and leads to more stable hemodynamics.

关 键 词：罗哌卡因 重度子痫前期 剖宫产 麻醉效果 腰麻 

分 类 号：R332[医药卫生—人体生理学]