盐酸罗哌卡因联合舒芬太尼对剖腹产患者术后镇痛效果及血流动力学影响

Effect of ropivacaine hydrochloride combined with sufentanil on analgesic effect and hemodynamics in patients undergoing caesarean section

目的探讨盐酸罗哌卡因联合舒芬太尼对剖腹产患者术后镇痛效果及其对患者血流动力学的影响。方法收集本院妇产科行剖腹产手术的患者100例,随机分为对照组与观察组,每组各50例。比较2组患者术后4 h、24 h、48 h时VAS疼痛评分及Ramsay镇静评分;比较2组患者术后48 h时,不良反应发生情况;分别于麻醉前、麻醉15 min、分娩后及手术结束后观察并记录2组患者心率(HR)、平均动脉压(MAP)及血氧饱和度(SPO2)。结果术后4 h、术后24 h及术后48 h,观察组患者VAS评分均明显低于对照组,Ramsay镇静评分均明显高于对照组(P<0.05)。术后48 h,观察组产妇恶心呕吐、皮肤瘙痒、头晕等不良反应发生率明显低于对照组(P<0.05)。麻醉前、麻醉15 min及手术结束后,2组患者HR、MAP及SPO2水平比较,差异无统计学意义(P>0.05)。与麻醉前比较,分娩后对照组患者HR显著升高,MAP及SPO_2显著降低(P<0.05)。分娩后,观察组患者HR水平明显低于对照组,MAP及SPO2水平明显高于对照组(P<0.05)。讨论盐酸罗哌卡因联合舒芬太尼用于剖腹产术后镇痛,可缓解患者术后疼痛,减少不良反应发生率并改善患者血流动力学紊乱,有助于患者术后恢复。

Objective To study the effect of ropivacaine hydrochloride combined with sufentanil on analgesic effect and hemodynamics in patients undergoing caesarean section. Methods 100 patients undergoing caesarean section in our hospital were randomly divided into control group and observation group, with 50 cases in each group. At 4 h, 24 h and 48 h after operation, the VAS pain score and Ramsay sedation score were compared between the two groups. The incidence of adverse reactions was compared between the two groups at postoperative 48 h. Before anesthesia, 15 min after anesthesia, after fetal childbirth and operation completed, the heart rate(HR), mean arterial pressure(MAP) and blood oxygen saturation(SPO2) were measured in two groups. Results Postoperatively at 4 h, 24 h and 48 h, the score of VAS in the observation group was significantly lower than that of the control group. The score of Ramsay sedation was significantly higher than that of the control group(P<0.05). Postoperatively at 48 h, the incidence of adverse reactions such as nausea, vomiting, pruritus and dizziness in the observation group was significantly lower than that in the control group(P<0.05). There was no significant difference the levels of HR, MAP and SPO2 between the two groups before anesthesia, after anesthesia 15 min and after the operation(P>0.05). Compared with the levels before anesthesia, after fetal childbirth the level of HR in control group increased significantly, while the levels of MAP and SPO2 decreased significantly(P<0.05). After fetal childbirth, the level of HR in the observation group was significantly lower than that in the control group, and the levels of MAP and SPO2 were significantly higher than those in the control group(P<0.05). Conclusion The combination of ropivacaine and sufentanil can relieve pain of patients after caesarean section. It can reduce the incidence of adverse reactions and improve the hemodynamic indexes, which can help the patients recover after operation.