罗哌卡因与布比卡因在剖宫产手术腰-硬联合麻醉中应用效果的比较研究

Application effect comparison of ropivacaine and bupivacaine on combined spinal epidural anesthesia for cesarean section

目的比较罗哌卡因与布比卡因在剖宫产手术腰-硬联合麻醉中的应用效果。方法选取眉山市彭山区第二人民医院2016年1—10月收治的剖宫产孕产妇120例,依照入院次序分为常规组与试验组,各60例。两组均采用腰-硬联合麻醉,常规组采取布比卡因进行麻醉,试验组采取罗哌卡因进行麻醉。比较两组患者给药前及给药后5、10 min生命体征(平均动脉压、心率、血氧饱和度)变化情况;感觉阻滞起效时间、感觉阻滞持续时间、运动阻滞起效时间、运动阻滞恢复时间;不良反应发生情况。结果给药前,两组平均动脉压、心率、血氧饱和度比较,差异无统计学意义(P>0.05);给药后5、10 min,两组平均动脉压、血氧饱和度比较,差异无统计学意义(P>0.05),试验组心率高于常规组(P<0.05)。试验组感觉阻滞起效、感觉阻滞持续、运动阻滞起效时间长于常规组,运动阻滞恢复时间短于常规组(P<0.05)。试验组不良反应发生率低于常规组(P<0.05)。结论与布比卡因比较,罗哌卡因在剖宫产手术腰-硬联合麻醉中的应用效果更好,对母体生命体征影响更小,安全性更高。

Objective To investigate the application effect of ropivacaine and bupivacaine on combined spinal epidural anesthesia for cesarean section.Methods A total of 120 pregnant women were selected from January to October 2016 in the Second People＇s Hospital of Pengshan District, which were divided into routine group and experimental group, 60 cases in each group.All pregnant women were given combined spinal epidural anesthesia, the routine group was given bupivacaine, experimental group was given ropivacaine.The vital signs （mean arterial pressure, HR, SpO2 ） before treatment and after treatment of 5, 10 min, onset time of sensory blockade, duration time of sensory blockade, onset time of motor block, recovery time of motor block, and the incidence of adverse reactions were compared between the two groups.Results Before treatment, no significant differences of mean arterial pressure, HR or SpO2 was found between the two groups （ P〉0.05 ） ; after treatment of 5, 10 rain, no significant differences of mean arterial pressure or Sp02 was found between the two groups （ P〉0.05 ） , the HR in experimental group was higher than routine group （ P〈0.05 ） .The experimental group of onset time of sensory blockade, duration time of sensory blockade, onset time of motor block were longer than routine group, recovery time of motor block was shorter than routine group （ P〈0.05 ） .The incidence rate of adverse reactions in experimental group was lower than routine group （ P〈0.05 ） .Conclusion Compared with bupivacaine, ropivacaine has a better effect on combined spinal cpidural anesthesia for cesarean section, it can has less influence on maternal vital signs, with higher safety.