罗哌卡因复合小剂量舒芬太尼腰硬联合麻醉用于剖宫产瘢痕部位妊娠患者剖宫产术的效果观察

Observation on Efficacy of Ropivacaine Combined with Low Dose of Sufentanil for Combined Spinal-Epidural Anesthesia in Cesarean Scar Pregnancy

目的:探讨罗哌卡因复合小剂量舒芬太尼腰硬联合麻醉用于剖宫产瘢痕部位妊娠患者剖宫产术的效果。方法:选取2016年4月至2018年7月黄冈市中心医院收治的剖宫产瘢痕部位妊娠拟行剖宫产术患者94例,按照随机数字表法分为对照组与观察组,每组47例。对照组患者给予罗哌卡因,观察组患者给予罗哌卡因复合小剂量舒芬太尼。对比两组患者的阻滞效果及产后不良反应发生情况的差异。结果:观察组患者的感觉、运动阻滞起效时间和运动阻滞维持时间明显短于对照组,感觉阻滞维持时间明显长于对照组,差异均有统计学意义(P<0.05);观察组患者产后不良反应发生率为10.6%(5/47),明显低于对照组的38.3%(18/47),差异有统计学意义(P<0.05)。结论:罗哌卡因复合小剂量舒芬太尼腰硬联合麻醉可显著加快剖宫产瘢痕部位妊娠患者行剖宫产术时的麻醉速度,延长感觉阻滞的维持时间,提高手术镇痛效果,并减少产后不良反应。

OBJECTIVE:To probe into the effects of ropivacaine combined with low dose of sufentanil for combined spinal-epidural anesthesia in cesarean scar pregnancy. METHODS:94 patients with cesarean scar pregnancy admitted into Huanggang Central Hospital from Apr. 2016 to Jul. 2018 were selected and divided into control group and observation group via random number table, with 47 cases in each group. The control group was given ropivacaine, while the observation group was given ropivacaine combined with low dose of sufentanil. Comparison of blocking effects and incidences of postpartum adverse drug reactions between two groups were compared. RESULTS:The onset time of sensory and motor blocking and the maintenance time of motor blocking of observation group were significantly shorter than those of the control group, the maintenance time of sensory blocking of observation group was significantly longer than that of the control group, with statistically significant differences(P<0.05);the incidence of postpartum adverse drug reactions of observation group was 10.6%(5/47), which was significantly lower than that of the control group(38.3%, 18/47), with statistically significant difference(P<0.05). CONCLUSIONS:The combination of ropivacaine and low dose of sufentanil for combined spinal anesthesia can significantly accelerate the anesthesia speed in operation of cesarean scar pregnancy, prolong the maintenance time of sensory blocking, improve analgesic effect and reduce postpartum adverse drug reactions.