罗哌卡因与布比卡因在剖宫产手术中麻醉效果比较

Comparison on the anesthesia effect of ropivacaine and bupivacaine in cesarean section surgery

目的探讨罗哌卡因与布比卡因在剖宫产手术中麻醉的临床应用效果。方法将收治的138例剖宫产手术孕产妇随机分为两组,观察组69例采取罗哌卡因腰一硬联合麻醉,对照组采用布比卡因腰一硬联合麻醉,术后并观察两组患者的麻醉效果,记录麻醉不良反应。结果观察组患者麻醉效果优良率为95.65%,对照组患者麻醉效果优良率为93.7%,两组相比差异无统计学意义(P>0.05),观察组患者感觉阻滞维持时间要比对照组时间短,差异有统计学意义(P<0.05),而感觉阻滞起效间、感觉阻滞最高平面固定时间、感觉恢复时间与对照组比较差异无统计学意义(均P>0.05),观察组运动阻滞起效时间长于对照组(P<0.05),运动阻滞维持时间少于对照组(P<0.05)。结论罗哌卡因与布比卡因用于剖宫产腰硬联合麻醉中的效果相当,但罗哌卡因对母体循环影响更小,感觉阻滞完善,镇痛效果更好,麻醉恢复快,安全、有效,不良反应发生率低,值得临床进一步推广使用。

Objective To explore the clinical application effect of ropivacaine and bupivacaine in cesarean section surgery. Methods 138 cases of gravida who received cesarean section surgery were randomly divided into two groups, 69 cases were included in observation group and received ropivacaine, meanwhile, the other 69 cases in control group used bupivacaine, observed the anesthesia effect of two groups, record adverse reactions during anesthesia. Results Good and excellent rate of observation group was 95.65%, and it was was 93.7% in the control group, there was no statistically significant differences between the two groups （P 〉 0.05 ）. Sensory block maintain time of observation group was shorter than the control group, the difference was statistically significant （P 〈 0. 05 ）. The differences of the time block start, maintenance time of highest plane during block and sensory recovery between the two groups were not statistically significant （ P 〉 0. 05 ）, the time block worked of observation group is longer than the control group （ P 〈 0. 05 ）, but the maintain time was less than the control group （ P 〈 0.05 ）. Conclusions Ropivacaine and bupivacaine were equal in anaesthesia effect, but ropivacaine showed less impact on the maternal circulation, sensory block is perfect, has better analgesia effect and anesthesia recovery soon, not only safe but effective, has low incidence of adverse reactions, worthy of further clinical application.