罗哌卡因复合氢吗啡酮腰椎麻醉用于剖宫产手术的效果  

Effect of ropivacaine combined with hydromorphone lumbar spinal anesthesia on cesarean section

作　　者：贾兰芹 杨海霞[1] 范文 Jia Lanqin;Yang Haixia;Fan Wen(Department of Anesthesiology,Anyang Maternal and Child Health Hospital,Anyang 455000,China)

机构地区：[1]河南省安阳市妇幼保健院麻醉科,455000

出　　处：《中国实用医刊》2021年第18期44-47,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析罗哌卡因复合氢吗啡酮腰椎麻醉用于剖宫产手术的效果。方法抽取2018年3月至2020年11月于安阳市妇幼保健院行剖宫产的产妇94例,按随机数字表法分为复合组与罗哌卡因组,每组47例。罗哌卡因组采用罗哌卡因腰椎麻醉,复合组采用罗哌卡因复合氢吗啡酮腰椎麻醉,对比两组麻醉优良率、麻醉效果(麻醉起效时间、麻醉平面)、麻醉前(T1)、麻醉后10 min(T2)、麻醉后30 min(T3)、术毕即刻(T4)血流动力学、疼痛因子水平、不良反应发生率。结果复合组麻醉优良率(95.74%)高于罗哌卡因组(78.72%),P<0.05;复合组麻醉起效时间短于罗哌卡因组,麻醉平面高于罗哌卡因组(P<0.05);T2、T3、T4时,复合组心率(HR)、血氧饱和度(SpO2)较罗哌卡因组低,且波动幅度较罗哌卡因组小(P<0.05);术后24 h,两组P物质(SP)、前列腺素E2(PGE2)、神经肽Y(NPY)水平高于术前,但复合组SP、PGE2、NPY水平低于罗哌卡因组(P<0.05);复合组不良反应发生率(10.64%)与罗哌卡因组(8.51%)比较,P>0.05。结论罗哌卡因复合氢吗啡酮腰椎麻醉应用于剖宫产术中,可提高麻醉效果,维持血流动力学稳定,降低疼痛因子水平,提高镇痛效果,且未见明显不良反应。Objective To analyze the effect of ropivacaine combined with hydromorphone lumbar spinal anesthesia on cesarean section.Methods A total of 94 cases of cesarean section in Anyang Maternal and Child Health Hospital from March 2018 to November 2020 were selected,and divided into the compound group and the ropivacaine group according to the random number table method,with 47 cases in each group.The ropivacaine group was given ropivacaine lumbar anesthesia,and the compound group was given ropivacaine combined with hydromorphone lumbar anesthesia.The anesthesia excellent rate,anesthesia effect(anesthesia onset time,level of anesthesia),hemodynamics before anesthesia(T1),10 min after anesthesia(T2),30 min after anesthesia(T3),immediately after the operation(T4),pain factor levels and incidence of adverse reactions of the two groups were compared.Results The excellent and good rate of anesthesia in the compound group(95.74%)was higher than that in the ropivacaine group(78.72%),P<0.05.The onset time of anesthesia in the compound group was shorter than that of the ropivacaine group,and the level of anesthesia was higher than that of the ropivacaine group(P<0.05).The heart rate(HR)and blood oxygen saturation(SpO2)of the compound group were lower than those of ropivacaine group at T2,T3 and T4,and the fluctuation was smaller than that of ropivacaine group(P<0.05).Twenty-four hours after operation,the levels of substance P(SP),prostaglandin E2(PGE2)and neuropeptide Y(NPY)in the two groups were higher than those before operation,but the levels of SP,PGE2 and NPY in the compound group were lower than those in the ropivacaine group(P<0.05).The incidence of adverse reactions in the compound group(10.64%)was compared with that in the ropivacaine group(8.51%),P>0.05.Conclusions Ropivacaine combined with hydromorphone lumbar spinal anesthesia used in cesarean section can improve the anesthesia effect,maintain hemodynamic stability,reduce the level of pain factors,and improve the analgesic effect,and the combined anesthesia does not

关 键 词：剖宫产 罗哌卡因 氢吗啡酮 腰椎麻醉 

分 类 号：R614[医药卫生—麻醉学]