罗哌卡因腰-硬联合麻醉对剖腹产孕妇血流动力学及麻醉质量的影响探究

Effect of Ropivacaine Combined with Lumbar-hard Anesthesia on Hemodynamics and Anesthesia Quality in Pregnant Women Undergoing Caesarean Section

目的旨在研究罗哌卡因腰-硬联合麻醉对剖腹产孕妇血流动力学及麻醉质量产生的影响。方法研究资料来源于方便选取2018年1-12月因剖宫产在该院接受诊治的孕妇共60例,将纳入该次研究的孕妇按照入院次序的单双号进行分组,入院次序为单号的30例患者作为对照组,使用较大剂量罗哌卡因进行腰-硬联合麻醉措施,将入院次序为双号的30例患者作为观察组,实施小剂量的罗哌卡因腰-硬联合麻醉措施,对比观察两种麻醉剂量对孕妇血流动力学及麻醉质量产生的影响。结果对比观察组患者与对照组麻醉质量相关指标(麻醉阻滞效果(1.13±1.05)分vs(2.94±1.30)分(t=9.338,P<0.05)、感觉阻滞起效时间(38.61±2.61)s vs (43.29±6.54)s(t=10.265,P<0.05)、运动阻滞起效时间(57.02±3.20)s vs (66.38±5.16)s(t=10.268,P<0.05)、Bromage评分(1.90±0.35)分vs (2.64±0.46)分(t=9.627,P<0.05));对照组患者动脉压、血样饱和度、心率等血流动力学变化情况波动较大,而观察组患者动脉压、血氧饱和度及心率波动幅度小,两组差异有统计学意义(P<0.05)。结论对于剖腹产孕妇实施小剂量罗哌卡因腰-硬联合麻醉在促进患者血流动力学稳定的同时,提升麻醉质量,值得推广。

Objective To study the effects of ropivacaine combined with lumbar-hard anesthesia on hemodynamics and anesthesia quality in caesarean section pregnant women. Methods Convenient selected the data were collected from 60 pregnant women who were admitted to this hospital from January to December 2018 for cesarean section. The pregnant women who were included in the study were divided into single and double numbers according to the order of admission. The order of admission was single. 30 patients were used as the control group. The high-dose ropivacaine was used for lumbar-hard anesthesia. 30 patients with the order of the double were used as the observation group. The low-dose ropivacaine waist-hard was implemented. Combined anesthesia measures, the effects of two anesthetic doses on the hemodynamics and anesthesia quality of pregnant women were compared. Results The anesthetic quality of the patients in the observation group and the control group (1.13±1.05)points vs (2.94±1.30)points(t=9.338, P<0.05) and the sensory block onset time (38.61±2.61)s vs (43.29±6.54) s (t=10.265, P<0.05), motor block onset time (57.02±3.20)s vs (66.38±5.16)s (t=10.268, P<0.05), Bromage score (1.90±0.35) points vs (2.64±0.46) points (t=9.627, P<0.05);hemodynamic changes such as arterial pressure, blood sample saturation, and heart rate fluctuated greatly in the control group, while arterial pressure and blood were observed in the observation group. The oxygen saturation and heart rate fluctuations were small(P<0.05), and the difference between the two groups was statistically significant(P<0.05). Conclusion Low-dose ropivacaine combined with lumbar-hard anesthesia for caesarean section in pregnant women can improve the hemodynamic stability of patients and improve the quality of anesthesia.