小剂量罗哌卡因蛛网膜下腔麻醉对剖宫产术镇痛效果及血清瘦素、LIF水平的影响  

Effects of low-dose ropivacaine subarachnoid anesthesia on analgesia effect of cesarean section and the levels of serum leptin and LIF

作　　者：黄杰[1] 李玉 HUANG Jie;LI Yu(Department of Anesthesiology,Hanzhong Central Hospital,Hanzhong,Shaanxi 723000,China)

机构地区：[1]陕西省汉中市中心医院麻醉科,陕西汉中723000

出　　处：《检验医学与临床》2022年第9期1205-1208,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨小剂量罗哌卡因蛛网膜下腔麻醉对剖宫产术镇痛效果及血清瘦素、白血病抑制因子(LIF)水平的影响。方法选取2018年6月至2021年5月在该院分娩的剖宫产产妇86例作为研究对象,根据随机信封抽签1∶1原则将产妇分为小剂量组与对照组,各43例。所有产妇给予蛛网膜下腔麻醉,小剂量组给予1 mL 0.75%罗哌卡因,对照组给予2 mL 0.75%罗哌卡因。记录麻醉情况、麻醉效果、并发症发生情况,检测并分析两组手术前后血清瘦素、LIF水平变化情况。结果两组麻醉起效时间、镇痛维持时间、达到阻滞平面时间与痛觉恢复时间比较,差异无统计学意义(P>0.05)。小剂量组剖宫产术后4、12、24 h的疼痛视觉模拟评分法(VAS)评分与对照组比较,差异无统计学意义(P>0.05)。小剂量组的麻醉效果优良率为100.0%,高于对照组的88.4%,差异有统计学意义(P<0.05)。小剂量组剖宫产术后7 d的并发症发生率为4.7%,低于对照组的27.9%,差异有统计学意义(P<0.05)。两组剖宫产术后7 d血清瘦素水平低于术后1 d,血清LIF水平高于术后1 d,差异有统计学意义(P<0.05);小剂量组术后7 d血清瘦素水平低于对照组,血清LIF水平高于对照组,差异有统计学意义(P<0.05)。结论小剂量罗哌卡因蛛网膜下腔麻醉用于剖宫产术可提高麻醉效果,减少术后并发症的发生,同时不影响镇痛效果,不增加麻醉时间,还可抑制瘦素的分泌,促进血清LIF水平升高。Objective To investigate the effect of low-dose ropivacaine subarachnoid anesthesia on the analgesic effect of cesarean section and the levels of serum leptin and leukemia inhibitory factor(LIF).Methods A total of 86 cases of parturient women underwent cesarean section in the hospital from June 2018 to May 2021 were selected as the research objects.According to the principle of 1∶1 random envelope lottery,parturient women were divided into low-dose group and control group,with 43 cases in each group.All parturient women were given subarachnoid anesthesia,the low-dose group was given 1 mL of 0.75%ropivacaine,and the control group was given 2 mL of 0.75%ropivacaine.The anesthesia conditions,anesthesia effects and complications were recorded,and the changes of serum leptin and LIF levels in the two groups were detected and analyzed.Results There was no significant difference in the onset time of anesthesia,the maintenance time of analgesia,the time to reach the block level and the time of pain recovery between the two groups(P>0.05).There was no significant difference in the visual analog scale(VAS)scores between the low-dose group and the control group at 4,12 h and 24 h after cesarean section(P>0.05).The excellent and good rate of anesthesia in the low-dose group was 100.0%,which was higher than 88.4% in the control group,and the difference was statistically significant(P<0.05).The complication rate at 7 d after cesarean section in the low-dose group was 4.7%,which was lower than 27.9% in the control group,and the difference was statistically significant(P<0.05).The serum leptin level at 7 d after cesarean section in the two groups was lower than that at 1 d after operation,and the serum LIF level was higher than that at 1 d after operation,and the differences were statistically significant(P<0.05).The serum leptin level in the low-dose group was lower than that in the control group at 7 d after operation,and the serum LIF level was higher than that in the control group at 7 d after operation,and the differences

关 键 词：罗哌卡因 蛛网膜下腔麻醉 剖宫产 瘦素 白血病抑制因子 

分 类 号：R614[医药卫生—麻醉学]