0.75%罗哌卡因在剖宫产手术三种麻醉方法中效果比较

Comparison of 0.75% ropivacaine used in continuous epidural,combined spinal-epidural and a single epidural anesthesia in cesarean section

目的比较0.75%罗哌卡因应用于连续硬膜外麻醉、腰-硬联合麻醉、单次硬膜外麻醉在剖宫产手术中的效果。方法选择单胎初产患者120例,随机分为三组,A组连续硬膜外组,B组腰-硬联合麻醉组,C组单次硬膜外组。术中观察平均动脉压、心率、血氧饱和度,记录麻醉镇痛效果和肌松满意度,起效时间及术中、术后并发症。结果三组患者平均动脉压、心率、血氧饱和度比较差异无统计学意义(P>0.05)。C组患者麻醉效果最好,满意率100%,B组次之,A组最差;起效时间,B组最快,C组次之,A组最慢,A组与B、C间差异有统计学意义。术中、术后并发症:A组有低血压1例,恶心呕吐2例;B组有低血压4例,恶心、呕吐5例,术后头痛2例;C组低血压1例。三组患者均无全脊髓麻发生。结论0.75%罗哌卡因结合单次硬膜外麻醉用于剖宫产手术是最好的麻醉方案。

Objective Comparison of 0.75% ropivacaine used in continuous epidural anesthesia, combined spinal - epidural anesthesia, a single epidural anesthesia in cesarean section the effect of surgery. Methods Choose a single early fetal production 120 eases of patients were randomly divided into three groups, group A of continuous epidural group, group B of combined spinal - epidural anesthesia, group C single epidural group. Intraoperative observation of mean arterial pressure, heart rate,oxygen saturation, records of narcotic analgesic and muscle relaxant effect of satisfaction, the onset time,and intraoperative and post- operative complications. Results Three groups of patients with mean arterial pressure, heart rate, oxygen saturation was no significant difference（ P 〈0.05）. Group C patients with the best anesthetic effect,satisfied with the rate of 100% ,group B of the second,group C of the worst ;onset time,group B growing fastest, C group of the second, group A was the slowest,A group and B, C between significant difference. Intraoperative and postoperative complications of low blood pressure A group 1 case,2 cases of nausea and vomiting; B group,4 cases of hypotension, nausea and vomiting in 5 cases, after 2 cases of headache ;C group, 1 case of low blood pressure. Three groups of patients with no occurrence of the whole spinal cord Ma. Conclusion 0.75% ropivaeaine combined with a single epidural anesthesia for cesarean section is the best program.