不同剂量舒芬太尼硬膜外麻醉对剖宫产者应激状态、血压影响  

Effects of the different doses of sufentanil used for epidural anesthesia during cesarean section of women on their stress state and blood pressure

作　　者：邢文灵 乔硕 李俊青 XING Wenling;QIAO Shuo;LI Junqing(Traditional Chinese Medicine Hospital of Funan County,Fuyang,Anhui Province,236300;Fuyang Hospital Affiliated to Anhui medical university,Fuyang,Anhui Province)

机构地区：[1]安徽省阜南县中医院,236300 [2]安徽医科大学附属阜阳医院

出　　处：《中国计划生育学杂志》2024年第2期322-325,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨硬膜外麻醉中不同剂量舒芬太尼联合罗哌卡因对剖宫产者应激状态及血压的影响。方法:选择本院2021年2月-2023年9月收治的计划剖宫产者92例,随机数字表法分为高剂量组和低剂量组各46例,两组均行硬膜外麻醉,高剂量组给予0.75%罗哌卡因10ml联合20μg舒芬太尼麻醉,低剂量组给予0.75%罗哌卡因10ml联合10μg舒芬太尼麻醉。对比两组麻醉效果,麻醉前后应激状态、血压水平,产妇疼痛情况、新生儿Apgar评分及并发症发生情况。结果:两组镇痛持续时间无差异,高剂量组感觉阻滞起效时间(8.24±1.58min)和运动阻滞起效时间(9.09±1.47min)均低于低剂量组(11.69±2.24min、12.03±2.11min),麻醉后内皮素-1(79.66±6.05pg/ml)、去甲肾上腺素(279.68±29.78pg/ml)、血清皮质醇(375.44±37.14ng/ml)水平均低于低剂量组(86.13±6.24pg/ml、314.49±30.25pg/ml、402.16±37.86ng/ml),麻醉后收缩压(112.13±5.37mmHg)、舒张压(79.42±3.77mmHg)水平高于低剂量组(106.85±6.52mmHg、65.16±3.69mmHg),并发症发生率(8.70%)低于低剂量组(28.26%)(均P<0.05);两组产妇视觉模拟评分和新生儿Apgar评分无差异(P>0.05)。结论:剖宫产术中20μg舒芬太尼联合罗哌卡因的麻醉效果最佳,且对产妇应激状态及血压水平的影响较小,安全性更高。Objective:To investigate the effects of the different doses of sufentanil used for epidural anesthesia during cesarean section of women on their stress state and blood pressure.Methods:92 pregnant women who wanted cesarean section were selected and were divided into group A and group B according to random number table method from Feb-ruary 2021 to September 2023.46 women in group A were given 0.75%ropivacaine 10ml combined with 20μg sufen-tanil for epidural anesthesia during cesarean section,and 46 women in group B were given 0.75%ropivacaine 10ml combined with 10μg sufentanil for epidural anesthesia during cesarean section.The anesthetic effect,the stress state before and after anesthesia,and the blood pressure value,the maternal pain situation,the neonatal Apgar score and the complication rate of the women were compared between the two groups.Results:There was no significant difference in the duration of analgesia of the women between the two groups.The onset time of sensory block(8.24±1.58 min)and the onset time of motor block(9.09±1.47 min)of the women in group A were significantly lower than those(11.69±2.24 min and 12.03±2.11 min)of the women in group B.The levels of endothelin-l(79.66±6.05 pg/ml),norepi-nephrine(279.68±29.78 pg/ml)and serum cortisol(375.44±37.14 ng/ml)of the women in group A were significant-ly lower than those(86.13±6.24 pg/ml,314.49±30.25 pg/ml and 402.16±37.86 ng/ml)of the women in group B.The values of the systolic blood pressure(112.13±5.37 mmHg)and the diastolic blood pressure(79.42±3.77 mm-Hg)of the women in group B after anesthesia were significantly higher than those(106.85±6.52 mmHg and 65.16±3.69 mmHg)of the women in group B.The incidence of complications(8.70%)of the women in group A was significantly lower than that(28.26%)of the women in group B(all P<0.05).There were no significant differences in the mater-nal score of visual analogue scale and the neonatal Apgar score between the two groups(P>0.05).Conclusion:20μg.sufentanil combined with ropivacaine used f

关 键 词：剖宫产术 硬膜外麻醉 不同剂量舒芬太尼 应激状态 血压 麻醉效果 

分 类 号：R614[医药卫生—麻醉学]