个性化麻醉护理对罗哌卡因腰硬联合麻醉剖宫产镇痛中的应用

Application of individualized anesthesia nursing in caesarean section of ropivacaine combined spinal epidural anesthesia analgesia

目的探讨个性化麻醉护理对罗哌卡因腰硬联合麻醉剖宫产镇痛中的应用。方法选取我院2015年6月~2016年7月行剖宫产手术产妇80例,按随机数字表法分为观察组(n=40)和对照组(n=40),所有患者均采用罗哌卡因腰-硬联合麻醉,对照组采用常规护理,研究组在对照组基础上采用个性化麻醉护理后,根据WHO制定的疼痛分级标准评价两组产妇的麻醉镇痛效果,比较两组产妇的手术时间、镇痛持续时间,以及采用新生儿Apgar 5min评分法评价新生儿身体状态,并观察两组产妇产后感染、低血压、产后出血及新生儿窒息的分娩并发症发生情况。结果观察组镇痛效果有效率为85.00%(34/40),明显高于对照组的镇痛有效率65.00%(26/40)(P<0.05);观察组的手术时间、药物起效时间均较对照组明显缩短(P<0.05);且观察组新生儿Apgar 5min评分与对照组相比高,差异有统计学意义(P<0.05);而观察组产后感染、低血压、产后出血及新生儿窒息的分娩并发症发生总率为7.50%(3/40),明显低于对照组25.00%(10/40)(P<0.05)。结论个性化麻醉护理有助于改善罗哌卡因腰硬联合麻醉剖宫产的镇痛效果,为剖宫产手术顺利进行提供安全可靠的保障,有助于保证母婴安全,值得临床上推广。

Objective To investigate application of individualized anesthesia nursing in caesarean section of ropivacaine combined spinal epidural anesthesia analgesia. Methods 80 cases of cesarean section in our hospital from June 2015 to July 2016 were selected. According to the number table method, the patients were randomly divided into observation group （n=40） and control group （n=40）. All patients were treated with ropivacaine combined spinal epidural anesthesia,, the control group with routine nursing, the research group with the use of personalized nursing after anesthesia, on the basis of routine nursing. According to the standard of pain classification established by WHO, the effect of two groups of women on narcotic analgesia was evaluated. The operation time and duration of analgesia were compared between the two groups. Evaluation of neonatal body status by Apgar 5min score. The complications of postpartum infection, hypotension, postpartum hemorrhage and neonatal asphyxia were observed in the two groups. Results The analgesic effect of observation group was 85.00% （34/40）, the effective rate of analgesia was significantly higher than the control group with 65.00% （26/40） （P 〈 0.05）. The operation time and drug onset time of the observation group were significantly shorter than those of the control group （P 〈 0.05）. And the observation group neonatal Apgar5min score was higher than the control group, and the difference was statistically significant （P 〈 0.05）. The incidence of postpartum complications of postpartum infection, hypotension, postpartum hemorrhage and neonatal asphyxia in the observation group was 7.50% （3/40）, which was significantly lower than that in the control group with 25.00%（10/40） （P 〈 0.05）. Conclusion Individualized anesthesia nursing is helpful to improve the analgesic effect of ropivacaine combined spinal epidural anesthesia for cesarean section. The cesarean section can provide a safe and reliable protection, and help ensure maternal and child safety. It is worthy of clinical promotion,