罗哌卡因与布比卡因对剖宫产手术腰-硬联合麻醉患者血流动力学的影响

Influences of ropivacaine and bupivacaine on hemodynamic in patients undergoing cesarean section with spinal-epidural anesthesia

目的观察罗哌卡因与布比卡因对剖宫产手术腰-硬联合麻醉患者血流动力学的影响。方法将98例择期进行剖宫产术的孕妇随机分为试验组49例和对照组49例。试验组予以0.75%罗哌卡因1.5 m L;对照组予以0.75%布比卡因1.5 m L。比较2组患者的血流动力学水平、麻醉效果及不良反应发生率。结果试验组麻醉5,10 min后的平均动脉压和收缩压显著高于对照组(P<0.05)。试验组的感觉平面阻滞和运动阻滞起效时间均显著长于对照组(P<0.05);试验组的感觉平面阻滞和运动阻滞维持时间均显著少于对照组(P<0.05)。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论罗哌卡因与布比卡因用于剖宫产手术均是安全、有效的,但罗哌卡因对血流动力学干扰较轻,且感觉平面阻滞和运动阻滞维持时间短,有助于恢复。

Objective To investigate the effects of ropivacaine and bupivacaine on hemodynamic in patients undergoing cesarean section with spinal-epidural anesthesia. Methods A total of 98 pregnant women undergoing elective cesarean section were randomly divided into treatment group（ 49 cases） and control group（ 49 cases）. The treatment group was received 0. 75% ropivacaine 1. 5 m L. Control group was received0. 75% bupivacaine 1. 5 m L. The hemodynamic level,the effect of anesthesia and the incidence of adverse drug reactions were compared between the two groups. Results Mean arterial pressure and systolic blood pressure in the treatment group were significantly higher than those in control group at 5 and 10 min after anesthesia（ P〈0. 05）. In the treatment group,the sensory level and motor block were significantly longer than those of control group（ P〈0. 05）. The time of sensory block and motor block in the treatment group were significantly less than those in control group（ P〈0. 05）. There was no significant difference in the incidence of adverse reactions between the two groups（ P〈0. 05）.Conclusion Ropivacaine and bupivacaine for caesarean section are safe and effective,but ropivacaine has less hemodynamic disturbances and short duration of sensory level block and motor block,and therefore more contribute to recovery.