罗哌卡因复合舒芬太尼腰硬联合麻醉用于剖宫产术对血流动力学及肌肉松弛程度的影响

Effect of Ropivacaine and Sufentanil Combined Spinal-Epidural Anesthesia for Cesarean Section on Hemodynamics and Muscle Relaxation

目的:探究罗哌卡因+舒芬太尼腰硬联合麻醉用于剖宫产术对血流动力学及肌肉松弛程度的影响。方法:前瞻性的选取2019年1月至2020年6月在我院行剖宫产手术的80例产妇,按照随机数字表法简单随机分为两组,对照组(40例)予以单纯罗哌卡因腰硬联合麻醉,观察组(40例)予以罗哌卡因+舒芬太尼腰硬联合麻醉。比较两组产妇麻醉前15min和麻醉后15min心率(HR)、收缩压(SBP)、舒张压(DBP)水平变化,麻醉后肌肉松弛程度、药物起效时间、镇痛时间、运动恢复时间、产妇Bromage运动评分、产后15min新生儿Apgar评分以及药物不良反应发生情况。结果:重复测量方差分析显示时点效应可以显著影响SBP、DBP、HR水平变化,时点和麻醉方式的交互效应可以显著影响SBP水平变化(P<0.05);且观察组麻醉后SBP降低程度较对照组小(均P<0.05)。观察组肌肉松弛优良率为97.50%,高于对照组的85.00%,差异有统计学意义(P<0.05)。观察组产妇药物起效时间、新生儿Apgar评分、产妇Bromage运动评分、镇痛时间及运动恢复时间与对照组比较,差异均无统计学意义(P>0.05)。结论:罗哌卡因+舒芬太尼腰硬联合麻醉用于剖宫产术对血流动力学影响较小,肌肉松弛优良率高,且不会影响产妇下肢功能和新生儿健康状况,药物安全性高。

Objective:To explore the effect of ropivacaine and sufentanil combined spinal-epidural anesthesia for cesarean section on hemodynamics and muscle relaxation.Methods:A prospective selection of 80 parturients who underwent cesarean section in our hospital from January 2019 to June 2020 were randomly divided into two groups according to the random number table method.The control group(40 cases)had ropivacaine combined spinal-epidural anesthesia,and the observation group(40 cases)had ropivacaine combined with sufentanil combined spinal-epidural anesthesia.The changes in heart rate(HR),systolic blood pressure(SBP),and diastolic blood pressure(DBP)levels 15 minutes before anesthesia and 15 minutes after anesthesia between the two groups of women were compared,as well as the degree of muscle relaxation after anesthesia,drug onset time,analgesia time,exercise recovery time,and maternal Bromage exercise score,Apgar score of newborns 15 minutes postpartum,and occurrence of adverse drug reactions.Results:Repeated measurement analysis of variance showed that the time point effect can significantly affect the changes in SBP,DBP and HR levels,and the interaction effect of time point and anesthesia methods can significantly affect the changes in SBP levels(P<0.05);and the decrease in SBP in the observation group after anesthesia was lower than that in the control group(all P<0.05).The excellent and good rate of muscle relaxation in the observation group was 97.50%,which was higher than 85.00%in the control group.The difference was statistically significant(P<0.05).Compared with the control group,the observation group had no statistically significant differences in the time of drug onset,Apgar score of the newborn,Bromage exercise score,analgesia time and exercise recovery time(P>0.05).Conclusion:Ropivacaine and sufentanil combined spinal-epidural anesthesia for cesarean section has little effect on hemodynamics,high rate of muscle relaxation,and does not affect the function of the lower limbs of the mother and the health of the newborn.The drug has high safety.