甲磺酸罗哌卡因蛛网膜下腔阻滞用于剖宫产术的临床观察

Clinical Application of Ropivacaine Mesylate for Subarachnoid Block in Cesarean Section

目的:观察不同浓度甲磺酸罗哌卡因及丁卡因蛛网膜下腔阻滞用于剖宫产术的麻醉效能、母婴安全和不良反应。方法:采用随机双盲法,将90例剖宫产手术的足月单胎产妇均分为三组(n=30):0.894%甲磺酸罗哌卡因组(L1组),1.192%甲磺酸罗哌卡因组(L2组)和1.0%丁卡因组(D组)。观察蛛网膜下腔阻滞后产妇的感觉阻滞起效和持续时间、运动神经阻滞程度、麻醉质量评价、术中BP、HR、SPO2变化、恶心、呕吐等不良反应及新生儿1m in和5 m in Apgar评分。结果:L1组比L2组和D组起效慢,阻滞平面低,平面固定时间长。L2组感觉阻滞持续时间比L1组和D组长。L2组和D组肌松评分优于L1组。D组术中低血压及恶心、呕吐发生率明显高于L1组和L2组。结论:1.192%甲磺酸罗哌卡因用于蛛网膜下腔阻滞剖宫产术,其麻醉效能等同于1.0%丁卡因,而副作用较1.0%丁卡因少。

Objective ：To compare the anesthesia efficiency and safety of different concentrations of ropivacaine mesylate with tetracaine in spinal anesthesia. Methods：Ninety parturients undergoing cesarean section were divided into three groups ：0.894% ropivacaine mesylate group （ L1, n = 30） , 1. 192% ropivacaine mesylate group （ L2, n = 30） and 1.0% tetracaine group （ D, n = 30）. The onset and duration of sensory block, the intensity of motor block, the quality of the anesthesia, adverse reactions, HR, BP, SPO2 during operation and Apgar score of neonates were measured and recorded, 1 min and 5 min after birth. The results were compared statistically. Results：Although there was no significant difference of the common conditions of pregnant women and the Apgar score of neonates among the three groups, the onset and duration time of sensory block and modifier bromage score （MBS） of motor block differ greatly among the three groups, and side - effects were significantly increased in group D com- pared with those in group i2 or group L1. Conclusions：The anesthesia efficiency of 1. 192% ropivacaine mesylate was as same as 1.0% tetracaine for subarachnoid block in Cesarean section, but side effects was less than 1.0% tetracaine .