小剂量罗哌卡因复合舒芬太尼在剖宫产蛛网膜下腔麻醉中的应用效果

Effects of low-dose ropivacaine combined with sufentanil in subarachnoid anesthesia for cesarean section

目的分析剖宫产蛛网膜下腔麻醉中应用小剂量罗哌卡因复合舒芬太尼的临床效果。方法选取焦作市妇幼保健院2018年5月至2019年7月收治的100例剖宫产产妇为研究对象,按照随机数字表法分为对照组与观察组,每组50例。对照组给予小剂量罗哌卡因进行麻醉,观察组产妇应用小剂量罗哌卡因复合舒芬太尼进行蛛网膜下腔麻醉。观察记录两组产妇的痛觉恢复时间、麻醉持续时间、麻醉起效时间、麻醉满意效果、尿潴留及皮肤瘙痒等不良反应发生情况、麻醉前后的心率和平均动脉压等临床指标。结果观察组与对照组产妇的痛觉恢复时间、麻醉持续时间、麻醉起效时间比较差异均有统计学意义(P均<0.05)。观察组产妇麻醉效果满意度为98.00%(49/50),高于对照组的80.00%(40/50),P<0.05。观察组不良反应发生率为4.00%(2/50),低于对照组的20.0%(10/50),P<0.05。麻醉前,两组产妇心率及平均动脉压比较差异未见统计学意义(P>0.05);麻醉后,观察组心率及平均动脉压均高于对照组,差异有统计学意义(P<0.05)。结论剖宫产蛛网膜下腔麻醉中应用小剂量罗哌卡因复合舒芬太尼的临床效果理想,安全性高,发生不良反应概率较低,能够有效提高麻醉满意度,对患者的血流动力学及呼吸情况影响较小。

Objective To analyze the clinical effects of low-dose ropivacaine combined with sufentanil in subarachnoid anesthesia for cesarean section.Methods One hundred women who underwent cesarean section in Jiaozuo Maternal and Child Health Hospital from May 2018 to July 2019 were selected as the study objects.And they were divided into observation group and control group according to the random number table method,with 50 cases in each group.The control group was anesthetized with low-dose ropivacaine,and the observation group was anesthetized with low-dose ropivacaine combined with sufentanil.The time of pain recovery,duration of anesthesia,onset time of anesthesia,satisfaction of anesthesia effect,occurrence of adverse reactions such as urinary residual and skin pruritus,heart rate and mean arterial pressure of the two groups before and after anesthesia were observed and recorded.Results There were significant differences in pain recovery time,anesthesia duration and anesthesia onset time between the observation group and control group(P<0.05).The satisfaction of anesthesia effect in the observation group was 98.00%(49/50),higher than the 80.00%(40/50)in the control group(P<0.05).The incidence of adverse reactions was 4.00%(2/50)in the observation group,lower than the 20.0%(10/50)in the control group(P<0.05).Before anesthesia,there was no significant difference in heart rate or mean arterial pressure between the two groups(P>0.05).After anesthesia,the heart rate and mean arterial pressure in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusions Low-dose ropivacaine combined with sufentanil in subarachnoid anesthesia for cesarean section has ideal anaesthetic effects,high safety and low incidence of adverse reactions.It can effectively improve the satisfaction of anesthesia,and has little effects on the hemodynamics and respiratory conditions of patients.