腰椎-硬膜外联合麻醉在剖宫产手术中的疗效研究

Therapeutic effect of lumbar-epidural combined anesthesia in cesarean section

目的分析低剂量罗哌卡因、舒芬太尼腰椎-硬膜外联合麻醉在剖宫产手术中的镇痛效果。方法选取2017年6-12月拟在该院行腰椎-硬膜外联合麻醉下剖宫产产妇160例,分为A、B组,各80例。A组给予0.5%罗哌卡因2 m L(10 mg)加4μg舒芬太尼联合麻醉,B组给予0.5%罗哌卡因2 m L(10 mg)加6μg舒芬太尼联合麻醉。比较两组术中追加硬膜外局部麻醉药剂量,产妇在术中、术后的不良反应发生情况,产妇满意度及新生儿Apgar评分。结果A组术中硬膜外局部麻醉药1%利多卡因使用剂量为(3.8±1.3)m L,B组为(3.1±1.2)m L;两组产妇的麻醉起效时间、镇痛时间、硬膜外局部麻醉药追加量比较,差异均无统计学意义(P>0.05)。A组产妇不良反应总发生率明显低于B组产妇(15.00%vs.56.25%,P<0.05)。两组产妇满意率及新生儿Apgar评分比较,差异均无统计学意义(P>0.05)。结论0.5%罗哌卡因2 m L与舒芬太尼4μg腰椎-硬膜外联合麻醉可用于剖宫产手术,不良反应发生率低,且对新生儿Apgar评分无明显影响。

Objective To analyse the analgesic effect of lumbar-epidural combined anesthesia with lowdose ropivacaine and sufentanil in cesarean section.Methods A total of 160 cases of patients received cesarean section under lumbar-epidural combined anaesthesia in this hospital from June to December 2017 were selected and divided into the group A and the group B,80 cases in each group.Patients in the group A were anesthetized with 0.5%ropivacaine 2 mL(10 mg)and 4μg sufentanil,while patients in the group B were anesthetized with 0.5%ropivacaine 2 mL(10 mg)and 6μg sufentanil.The dosage of additional epidural anesthesia,the incidence rate of adverse reactions during and after surgery,maternal satisfaction rate and neonatal Apgar score were compared between the two groups.Results The dose of 1%lidocaine for epidural local anesthesia was(3.8±1.3)mL,and that of group B was(3.1±1.2)mL;no statistically significant difference was found in the onset time of anesthesia,the time of analgesia,the dose of epidural local anesthetics in the two groups(P>0.05).The total incidence of adverse reactions in the group A was significantly lower than that in the group B(15.00%vs.56.25%,P<0.05).There was no significant difference in the maternal satisfaction rate and neonatal Apgar score between the two groups(P>0.05).Conclusion The lumbar-epidural combined anesthesia with 0.5%ropivacaine 2 mL and sufentanil 4μg has low incidence of adverse reactions and no significant effect on neonatal Apgar scores,which can be used in caesarean section surgery.