等剂量等溶度罗哌卡因和布比卡因腰麻-硬膜外联合麻醉用于子宫下段剖宫产的比较

Comparison of Isodose Ropivacaine and Bupivacaine for Combined Spinal-Epidural Anesthesia in Low Cesarean Section

目的观察相同剂量的罗哌卡因和布比卡因腰硬联合麻醉在剖宫产术中的麻醉效果和不良反应。方法选择60例择期子宫下段剖宫产术产妇随机分为两组各30例,均采用腰麻-硬膜外联合麻醉,其中A组采用罗哌卡因进行局麻,B组采用布比卡因进行局麻。比较两组的麻醉效果,同时观察不良反应的发生情况。结果在感觉阻滞起效时间上,A组<B组(P<0.05);在运动阻滞起效时间上A组>B组(P<0.05);在麻醉持续时间上,A组<B组(P<0.05);在双下肢完全恢复时间上,A组<B组(P<0.05);在低血压、恶心呕吐等不良反应的发生率上,A组<B组。结论罗哌卡因和布比卡因腰硬联合麻醉用于子宫下段剖宫产术均能取得满意的麻醉效果,但考虑到不良反应,罗哌卡因更适合子宫下段剖宫产术的腰硬联合麻醉。

Objective To observe the anesthetic effect and side effect of 0.5% ropivacaine and 0.5% bupivacaine for combined spinal-epidural anesthesia （CSEA） in low cesarean section. Methods Sixty maternity patients with elective low cesarean section were selected and divided into two groups, with 30 cases in each group. All cases received CSEA. Group A received the 0.5% ropivacaine and group B received 0.5% bupivacainc for local anesthesia. The anesthetic effect and side effect of two groups were observed and compared. Results ①The onset time of sensory in group A was less than that in group B （P 〈0.05）; ②The onset time of motor block in group A was longer than that in group B （P 〈0.05）; ③The duration of anesthesia in group A wan shorter than that in group B （P 〈0.05）; ④The complete recovery time of lower limbs in group A was shorter than that in group B （P 〈0.05）; ⑤The incidence of hypotension, nausea and vomiting in group A was lower than that in group B. Conclusions Both ropivacaine and bupivacaine can achieve satisfying anesthetic effect in the CSEA for low cesarean section, but ropivacaine is more suitable in consideration of the side effect.