蛛网膜下腔麻醉中两种麻醉药物对剖宫产患者的效果对比

Comparison of the Effect of Two Kinds of Anesthetics in Subarachnoid Anesthesia on Patients with Cesarean Section

目的:探讨罗哌卡因、布比卡因两种麻醉药物在剖宫产蛛网膜下腔麻醉中的效果。方法:本次研究选取2018年6月-2019年5月笔者所在医院进行蛛网膜下腔麻醉的120例剖宫产患者,根据随机数字表法分为两组,对照组患者使用布比卡因进行麻醉,研究组患者使用罗哌卡因进行麻醉。对两组患者麻醉前(T0)、麻醉后5 min(T1)、麻醉后10 min(T2)三个时间点的血流动力学进行检测,对比分析两组患者的临床麻醉效果。结果:研究组患者T1、T2的HR水平明显高于对照组,且研究组患者的运动阻滞起效时间及最大运动阻滞时间均长于对照组,运动阻滞维持时间明显短于对照组;研究组患者的感觉阻滞维持时间明显短于对照组,差异均有统计学意义(P<0.05);两组感觉阻滞起效时间、达到最高平面时间及各时间点MAP、SpO2比较,差异无统计学意义(P>0.05)。结论:在剖宫产手术蛛网膜下腔麻醉中,罗哌卡因、布比卡因两种麻醉药对患者各时间点的动脉压及血氧饱和度影响无明显差异,但是罗哌卡因可使患者手术过程中心率长时间维持在稳定状态,提高手术安全性。另外,罗哌卡因最大运动阻滞时间较为理想,而布比卡因运动及感觉阻滞维持时间较为理想,药物选择时需依照患者手术要求及自身情况酌情使用。

Objective:To investigate the anesthetic effect of Ropivacaine and Bupivacaine in subarachnoid anesthesia on patients with cesarean section.Method:A total of 120 cases of cesarean section patients with subarachnoid anesthesia in our hospital from June 2018 to may 2019 were selected and divided into two groups by random number method.The control group was given Bupivacaine for anesthesia,and the study group was given Ropivacaine for anesthesia.The hemodynamics of two groups of patients before anesthesia(T0),5 min after anesthesia(T1),10 min after anesthesia(T2)were detected,and the clinical anesthesia effect of the two groups was compared and analyzed.Result:The HR levels of T1 and T2 in the study group were significantly higher than those in the control group.Moreover,the onset time and maximum motor block time of the study group were longer than those of the control group,and the maintenance time of motor block was significantly shorter than that of the control group;the duration of sensory block in the study group was significantly shorter than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in the onset time of sensory block,the time of reaching the highest plane,MAP and SpO2 at each time point between the two groups(P>0.05).Conclusion:In the subarachnoid anesthesia of cesarean section,Ropivacaine and Bupivacaine have no significant difference on the arterial pressure and blood oxygen saturation of patients at different time points,but Ropivacaine can keep the heart rate of patients in a stable state for a long time and improve the safety of operation.In addition,the maximum motor block time of Ropivacaine is ideal,while the duration of motor and sensory block of Bupivacaine is ideal.The drug selection should be based on the operation requirements of patients and their own conditions.