不同浓度轻比重罗哌卡因联合舒芬太尼硬腰麻对剖宫产手术患者应激和炎症水平的影响  

Effects of different concentrations of light specific gravity ropivacaine combined with sufentanil on stress and inflammation in patients undergoing cesarean section

作　　者：徐鑫怡 叶光磊 王超 张爱荣 Xu Xin-yi;Ye Guang-lei;Wang Chao;Zhang Ai-chao(Cangzhou People’s Hospital,Cangzhou 061000)

机构地区：[1]沧州市人民医院,沧州061000

出　　处：《湖南师范大学学报（医学版）》2022年第3期93-96,共4页Journal of Hunan Normal University(Medical Sciences)

基　　金：沧州市重点研发计划指导项目(183302079)。

摘　　要：目的:对比分析两种常用轻比重浓度0.375%和0.5%罗哌卡因联合舒芬太尼硬腰麻对剖宫产手术患者应激和炎症水平的影响.方法:纳入2016年3月~2020年3月在我院行剖宫产术后的产妇300例,作为研究对象,采用随机数字表法分为观察组和对照组,每组各150例.观察组采用0.5%罗哌卡因和枸橼酸舒芬太尼注射液,对照组采用0.375%罗哌卡因和枸橼酸舒芬太尼注射液.观察两组麻醉前后的收缩压、舒张压、心率、内皮素-1(ET-1)、去甲肾上腺素(NE)、血清皮质醇(Cor)、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6),新生儿Apgar评分、视觉疼痛模拟评分(VAS)和药物不良反应.结果:两组患者麻醉前后,收缩压、舒张压和心率的差异不明显,无统计学意义;与麻醉前相比,在麻醉后48h,两组患者ET-1、NE、Cor、TNF-α和IL-6水平都升高,对照组升高的幅度更大,差异具有统计学意义;观察组和对照组新生儿出生后1、5min平均Apgar评分差异不明显;两组患者在术后1h、3h、5h和7hVAS评分比较,差异无统计学意义;与术后1h相比,两组患者术后3h、5h和7h的VAS评分明显下降,差异具有统计学意义,观察组的不良反应发生率为4.00%,对照组为1.33%,对照组不良反应发生率低于观察组,但差异无统计学意义.结论:与0.375%的轻比重罗哌卡因相比,0.5%的轻比重罗哌卡因联合舒芬太尼硬-腰麻可以降低剖宫产手术产妇的应激水平和炎症水平,并且对婴儿的安全性和不良反应的发生率相似.Objective To compare and analyze the effects of two common light specific gravity concentrations of 0.375%and 0.5%ropivacaine combined with sufentanil on stress and inflammation in patients undergoing cesarean section.Methods 300 pregnant women who underwent cesarean section in our hospital from March 2016 to March 2020 were included as the re-search object.They were randomly divided into observation group and control group,with 150 cases in each group.The obser-vation group was treated with 0.5%ropivacaine and sufentanil citrate injection,and the control group was treated with 0.375%ropivacaine and sufentanil citrate injection.Systolic blood pressure,diastolic blood pressure,heart rate,endothelin-1(ET-1),noradrenaline(NE),serum cortisol(COR)and serum tumor necrosis factor were observed before and after anesthesia-α(Tumor necrosis factor-α,TNF-α).Results There was no significant difference in systolic blood pressure,diastolic blood pressure and heart rate between the two groups before and after anesthesia;compared with before anesthesia,ET-1,NE,cor and TNF in the two groups 48 hours after anesthesia-αAnd IL-6 levels were increased,and the difference was statistically significant in the control group;there was no significant difference in the average Apgar score at 1 and 5 minutes after birth between the ob-servation group and the control group;there was no significant difference in the VAS scores at 1H,3h,5h and 7h after operation between the two groups.Compared with 1h after operation,the VAS scores of the two groups decreased significantly at 3h,5h and 7h after operation.The incidence of adverse reactions in the observation group was 4.00%,and that in the control group was 1.33%.The incidence of adverse reactions in the control group was lower than that in the observation group,but the difference was not statistically significant.Conclusion Compared with 0.375%light specific gravity ropivacaine,0.5%light specific grav-ity ropivacaine combined with sufentanil hard spinal anesthesia can reduce the stress leve

关 键 词：罗哌卡因 舒芬太尼 剖宫产 

分 类 号：R719.8[医药卫生—妇产科学]