0.5%和0.375%罗哌卡因腰硬联合麻醉用于剖宫产术中麻醉的效果观察

Comparison of the anesthesia effect of cesarean section in waist hard joint anesthesia use 0.5% and 0.375% ropivacaine

目的比较0.5%和0.375%轻比重罗哌卡因腰硬联合麻醉用于剖宫产术麻醉的效果。方法将拟行剖宫产的产妇232例随机分为A组(腰麻药为0.5%盐酸罗哌卡因)和B组(腰麻药为0.375%盐酸罗哌卡因),每组116例。记录麻醉前、切皮时、胎儿娩出后5 min的心率(HR)、收缩压(SBP)、舒张压(DBP),观察产妇术中的血管活性药、辅助药,记录术者、产妇满意率。结果两组产妇在麻醉前、胎儿娩出后5 min的SBP、DBP比较差异无统计学意义(P>0.05);两组在切皮时的SBP、DBP、HR和胎儿娩出后5 min的HR比较差异有统计学意义(P<0.05);A组血管活性药用量多于B组(P<0.05);A组术者满意率高于B组(P<0.05)。结论 0.5%和0.375%罗哌卡因腰硬联合麻醉行剖宫产都是安全有效的麻醉浓度,两种浓度镇痛效果好,前者对循环的影响较大,但肌松效果较好,术者满意率高,是腰硬联合麻醉中较适当的麻醉浓度。

Objective To compare the anesthesia effect of 0.5% and 0.375% light weight ropivacaine cesarean section in combined spinal lepidural anesthesia.Methods The 232 pregnant women schedule for cesarean section were randomly divided into group A（lumbar anesthesia was 0.5% hydrochochloric acid ropivacaine） and group B（lumbar anesthesia was 0.375% hydrochloric acid ropivacaine）,with 116 cases in each group.The HR and SBP,DBP successively before anesthesia,skin incision and 5 mins after fetal delivery were all recorded.The vascular active drugs and the adjuvant drug in the active medicine were observed,and the satisfaction rate of performer and maternal was recorded.Results There were no statistically significant differences between the two groups in SBP,DBP before anesthesia and 5 mins after fetal delivery（P 〉0.05）; While there were statistically significant differences between the two groups of SBP,DBP,HR over skin incision,and the HR also have significant differences when 5 min after fetal delivery（P 〈0.05）; Group A used more vascular active drug dosage than group B（P 〈0.05）; The performer satisfaction of group A was higher than that of group B（P 〈0.05）.Conclusion 0.5% or 0.375% hydrochloric acid ropivacaine are both safe and effective anesthetic concentration in combined spinal epidural anesthesia during cesarean section.The analgesic effect are both good,but the former has bigger impact on blood circulation,but it also has better muscle relaxant and higher satisfaction rate,so it is more reasonable for the combined spinal epidural anesthesia.