0.5%罗哌卡因腰硬联合麻醉时不同注药速度对剖宫产麻醉效果的观察

Effect observation of different injection speed of 0.5% ropivacaine on combined spinal-epidural anesthesia for caesarean section

目的观察剖宫产患者0.5%罗哌卡因腰硬联合麻醉时不同注药速度的麻醉效果。方法选取剖宫产患者126例随机分三组(n=42),穿刺成功后注入0.5%罗哌卡因2mL(Ⅰ组:1mL/5s,Ⅱ组:1mL/10s,Ⅲ组:1mL/15s)。观察并记录阻滞平面达到T10及消退到T8的时间、肌松满意度、最大运动阻滞程度、注药后MAP变化、不良反应等。结果与Ⅰ组比较,Ⅱ、Ⅲ组在阻滞平面达到T10及消退到T8的时间均延长,不良反应发生率低,差异有统计学意义(P<0.05)。结论 0.5%罗哌卡因以1mL/10s速度注药在腰硬联合阻滞麻醉下剖宫产,能获得较满意的麻醉效果及相对稳定的血压,值得临床推广。

Objective Objective To investigate the effects of combined spinal-epidural block with different injection speed of 0.5% ropivacaine on patients undergoing cesarean section.Methods0ne hundred and twenty-six patients underwent cesarean section were randomLy divided into three groups（n=42）.All patients received 0.5% ropivacaine 2mL subarachnoid injection with different speeds （the speeds of injection in groupⅠ,groupⅡand groupⅢ were 1mL/5 seconds,1mL/10 seconds and 1mL/15 seconds）. The time of block level reaching to T10 and regressing to T8,the satisfactory of muscle relaxation, the maximum motor blockage, changes of MAP and adverse reaction were observed and recorded.ResultsCompared with group Ⅰ,the time in groupⅡand Ⅲ of block plane reaching to T10 and degrading to T8 was prolonged and adverse reaction in groupⅡand Ⅲ were lower（P〈0.05）,the difference were significant. Conclusion Combined spinal- epidural anesthesia of 0.5% ropivacaine with injection speed 1mL/10 seconds for cesarean section has satisfied anesthesia effect and relatively stability of haemodynamics,it is worthy of clinical promotion.