罗哌卡因与芬太尼腰硬联合麻醉对妊娠合并急性阑尾炎患者牵拉反应及胎儿生长发育的影响  

Effects of combined spinal-epidural anesthesia with ropivacaine and fentanyl on traction response and fetal growth and development in pregnant patients with acute appendicitis

作　　者：姚新峰 YAO Xinfeng(Department of Anesthesiology,Changzhou Maternal and Child Health Care Hospital,Changzhou,Jiangsu,213000,China)

机构地区：[1]常州市妇幼保健院麻醉科,江苏常州213000

出　　处：《当代医学》2024年第34期142-144,共3页Contemporary Medicine

摘　　要：目的探讨罗哌卡因与芬太尼腰硬联合麻醉对妊娠合并急性阑尾炎患者牵拉反应及胎儿生长发育的影响。方法回顾性分析2012年1月至2020年1月常州市妇幼保健院收治的80例妊娠合并急性阑尾炎患者的临床资料,根据麻醉方法不同分为A组(n=45)与B组(n=35)。A组实施罗哌卡因联合芬太尼腰硬联合麻醉,B组实施静脉全身麻醉,比较两组疼痛情况、术中牵拉反应及胎儿后期生长情况。结果两组术中牵拉反应发生率比较差异无统计学意义;术后12、24 h,A组视觉模拟评分法评分均低于B组,差异有统计学意义(P<0.05);随访6个月后,A组胎儿智力发展指数及运动发展指数评分均高于B组,差异有统计学意义(P<0.05)。结论罗哌卡因与芬太尼腰硬联合麻醉用于妊娠合并急性阑尾炎患者中效果较好,可缓解患者术后疼痛程度,且不影响胎儿后期智力及运动的发育。Objective To investigate the effects of ropivacaine combined with fentanyl for lumbar epidural anesthesia on traction response and fetal growth in pregnant patients with acute appendicitis.Methods The clinical data of 80 pregnant patients with acute appendicitis admitted to Changzhou Maternal and Child Health Care Hospital from January 2012 to January 2020 were retrospectively analyzed,and they were divided into the group A(n=45)and the group B(n=35)according to different anesthesia methods.The group A was given ropivacaine combined with fentanyl,and the group B was given with intravenous general anesthesia,the pain,intraoperative traction reaction and fetal growth were compared between the two groups.Results There was no significant difference in the incidence of intraoperative traction reaction between the two groups.At 12 and 24 h after surgery,the visual analogue scale scores in the group A were lower than those in the group B,and the differences were statistically significant(P<0.05).After 6 months of follow-up,the scores of mental development index and psychomotor development index in the group A were higher than those in the group B,and the differences were statistically significant(P<0.05).Conclusion Ropivacaine combined with fentanyl lumbar anesthesia in pregnant patients with acute appendicitis is effective,can relieve postoperative pain,and does not affect the fetal intelligence and motor development in the later period.

关 键 词：妊娠合并急性阑尾炎 罗哌卡因 芬太尼 腰硬联合麻醉 静脉全身麻醉 牵拉反应 胎儿 生长发育 

分 类 号：R61[医药卫生—外科学]