不同浓度罗哌卡因在剖宫产手术中的应用研究  

Application study of different concentrations of ropivacaine for cesarean section

作　　者：杨阳[1] 窦艳[1] 黄皓 刘长慧[1] 顾恩华 YANG Yang;DOU Yan;HUANG Hao;LIU Chang-hui;GU En-hua(Department of Anesthesiology,Tianjin Hongqiao Hospital,Tianjin 300131,China)

机构地区：[1]天津市红桥医院麻醉科,天津300131

出　　处：《中国城乡企业卫生》2022年第10期1-4,共4页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：目的观察不同浓度罗哌卡因腰硬联合阻滞在剖宫产手术中的应用效果,为临床剖宫产的麻醉选择提供参考。方法选取2019年1—12月在天津市红桥医院行剖宫产手术的产妇80例作为研究对象,按随机数字表法分为对照组和观察组各40例。观察组采用0.375%浓度罗哌卡因行腰硬联合阻滞,对照组采用0.5%浓度罗哌卡因行腰硬联合阻滞,比较两组产妇生命体征[收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(SpO_(2))]、麻醉效果(感觉和运动阻滞起效时间、运动阻滞恢复时间、术中疼痛评分)、新生儿Apgar评分、麻醉不良反应发生率。结果麻醉阻滞后,观察组SBP、DBP、HR、SpO_(2)指标高于对照组;观察组感觉和运动阻滞起效时间均长于对照组,而运动阻滞恢复时间短于对照组;观察组切皮时、取胎时、手术结束前VAS评分均高于对照组;观察组产妇麻醉相关不良反应发生率为7.50%,低于对照组的17.50%,差异均有统计学意义(P<0.05)。两组新生儿出生1 min、5 min的Apgar评分比较,差异均无统计学意义(P>0.05)。结论低浓度罗哌卡因更适合剖宫产手术产妇的麻醉,虽然阻滞起效时间较对照组长,但生命体征较平稳、不良反应少、恢复快、安全性高,值得临床推广应用。Objective To observe the application effect of lumbar epidural block with different concentrations of ropivacaine in cesarean section,and to provide reference for anesthesia selection in clinical cesarean section.Methods Eighty parturients who underwent cesarean section in Tianjin Hongqiao Hospital from January to December 2019 were selected as the study objects and divided into the control group and the observation group by random number table method,with 40 cases in each group.The observation group was treated with 0.375%ropivacaine for lumbar epidural block and the control group was treated with 0.5%ropivacaine for lumbar epidural block.The vital signs[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),blood oxygen saturation(SpO_(2))],anesthetic effect(onset time of sensory and motor block,recovery time of motor block,intraoperative pain score),Apgar score of newborns and incidence of adverse effects of anesthesia were compared between the two groups.Results After anesthesia block,SBP,DBP,HR and SpO_(2)in the observation group were higher than those in the control group;the onset time of sensory and motor block in the observation group were longer than those in the control group,and the recovery time of motor block was shorter than that in the control group;VAS scores of the observation group were higher than those of the control group at the time of skin cutting,fetal removal and before the end of operation;the incidence rate of anesthesia related adverse reactions in the observation group was 7.50%,which was lower than that in the control group with 17.50%,and the differences were statistically significant(P<0.05).There were no significant difference in Apgar scores between newborns in the two groups at 1 min and 5 min after birth(P>0.05).Conclusion Low concentration ropivacaine was more suitable for anesthesia of parturients undergoing cesarean section operation.Although the onset time of block was longer than that of the control group,the vital signs were more stable,the adverse rea

关 键 词：剖宫产 罗哌卡因 椎管阻滞 生命体征 

分 类 号：R452[医药卫生—治疗学]