罗哌卡因复合舒芬太尼腰-硬联合麻醉在剖宫产术中的应用效果

Application effect of ropivacaine combined with sufentanil combined spinalepidural anesthesia in cesarean section

目的比较剖宫产术中应用罗哌卡因腰-硬联合麻醉和罗哌卡因复合舒芬太尼腰-硬联合麻醉的临床效果。方法回顾性分析2018年9月至2019年7月92例接受剖宫产术产妇的临床资料,按照麻醉方法不同将其分为罗哌卡因组和罗哌卡因+舒芬太尼组,每组46例。罗哌卡因组给予罗哌卡因腰-硬联合麻醉,罗哌卡因+舒芬太尼组给予罗哌卡因复合舒芬太尼腰-硬联合麻醉。观察两组麻醉前、手术开始时的收缩压(SBP)、舒张压(DBP)、呼吸频率、心率(HR)、药物起效时间、痛觉恢复时间、术后24 h不良反应发生情况、麻醉后肌肉松弛优良率。结果手术开始时,两组SBP、DBP、呼吸频率、HR均明显下降,但罗哌卡因+舒芬太尼组下降程度明显低于罗哌卡因组(P<0.05)。罗哌卡因+舒芬太尼组药物起效时间明显短于罗哌卡因组,痛觉恢复时间明显长于罗哌卡因组(P<0.05)。罗哌卡因+舒芬太尼组术后24 h不良反应总发生率明显低于罗哌卡因组(P<0.05)。罗哌卡因+舒芬太尼组麻醉后肌肉松弛优良率明显高于罗哌卡因组(P<0.05)。结论罗哌卡因复合舒芬太尼腰-硬联合麻醉应用于剖宫产术中的临床效果显著,可广泛推广。

Objective To compare the clinical effects of ropivacaine combined spinal-epidural anesthesia and ropivacaine combined with sufentanil combined spinal-epidural anesthesia in cesarean section.Methods The clinical data of 92 pregnant women undergoing cesarean section from September 2018 to July 2019 were retrospectively analyzed.According to different anesthesia methods,the pregnant women were divided into ropivacaine group and ropivacaine+sufentanil group,with 46 cases in each group.The ropivacaine group was given ropivacaine combined spinal-epidural anesthesia,the ropivacaine+sufentanil group was given ropivacaine combined with sufentanil combined spinal-epidural anesthesia.Systolic blood pressure(SBP),diastolic blood pressure(DBP),respiratory rate,heart rate(HR)before anesthesia and at the beginning of operation,drug onset time,pain recovery time,postoperative 24 h adverse reactions,excellent and good rate of muscle relaxation after anesthesia were observed between the two groups.Results At the beginning of operation,SBP,DBP,respiratory rate and HR of the two groups significantly decreased,but the decrease degree of the ropivacaine+sufentanil group were significantly lower than those of the ropivacaine group(P<0.05).The drug onset time of the ropivacaine+sufentanil group was significantly shorter than that of the ropivacaine group,and the pain recovery time was significantly longer than that of the ropivacaine group(P<0.05).The total incidence of postoperative 24 h adverse reactions in the ropivacaine+sufentanil group was significantly lower than that in the ropivacaine group(P<0.05).The excellent and good rate of muscle relaxation after anesthesia in the ropivacaine+sufentanil group was significantly higher than that in the ropivacaine group(P<0.05).Conclusion The ropivacaine combined with sufentanil combined spinal-epidural anesthesia applied in cesarean section has significant clinical effect,which can be widely promoted.