罗哌卡因复合舒芬太尼在剖宫产麻醉中的应用

The application of ropivacaine combined with sufentanil in anesthesia for cesarean section

目的探讨罗哌卡因复合舒芬太尼在剖宫产产妇麻醉中的应用价值。方法选取辽宁省铁岭市中心医院产科2017年2月至2020年4月收诊的剖宫产产妇共120例,采用随机数字表法分为两组,每组各60例,对照组给予单纯0.75%罗哌卡因腰硬联合麻醉,观察组给予0.75%罗哌卡因复合舒芬太尼腰硬联合麻醉,对比两组的麻醉不良反应发生率、术中血流动力学等。结果两组患者t0时的心率、平均动脉压、血氧饱和度比较,差异均无统计学意义(P>0.05);两组的心率和平均动脉压均呈先升后降趋势,血氧饱和度呈先降后升趋势,其中观察组t_(1)、t_(2)、t_(3)时的心率均低于对照组(P<0.05);观察组t_(1)、t_(2)时的平均动脉压低于对照组,血氧饱和度高于对照组(P<0.05);两组t_(3)时的平均动脉压和血氧饱和度比较,差异无统计学意义(P>0.05);观察组的恶心呕吐、牵拉反射发生率与对照组比较,差异无统计学意义(P>0.05);观察组的低血压、心动过缓发生率及总麻醉不良反应发生率均低于对照组(P<0.05);观察组的麻醉起效时间短于对照组,镇痛持续时间长于对照组(P<0.05)。结论罗哌卡因复合舒芬太尼腰硬联合麻醉在剖宫产术麻醉中应用效果肯定,能快速见效,稳定术中血流动力学,减少麻醉不良反应,且镇痛效果更佳,值得推广。

Objective To explore the application value of ropivacaine combined with sufentanil in anesthesia for cesarean section.Methods A total of 120 puerperae undergoing cesarean section admitted to the obstetrics department of our hospital from February 2017 to April 2020 were selected as the study subjects.They were divided into two groups by random number table method,each group has 60 cases.The control group were given combined spinal and epidural anesthesia with 0.75%ropivacaine,while the observation group were given combined spinal and epidural anesthesia with 0.75%ropivacaine combined with sufentanil.The incidence of adverse anesthetic reactions and intraoperative hemodynamics were compared between the two groups.Results There were no statistically significant differences between the two groups in heart rate,mean arterial pressure and oxygen saturation at t_(0)(P>0.05).The heart rate and mean arterial pressure in both groups tended to rise and then fall,while the oxygen saturation tended to fall and then rise,and the heart rates at t_(1),t_(2) and t_(3) in the observation group were lower than those in the control group(P<0.05).The mean arterial pressure at t_(1) and t_(2) in the observation group was lower than that in the control group,while the oxygen saturation at t_(1) and t_(2) in the observation group was higher than that in the control group(P<0.05).There were no statistically significant differences between the two groups in mean arterial pressure and oxygen saturation at t3(P>0.05).Meanwhile,there were no statistically significant differences between the two groups in the incidences of nausea and vomiting and stretch reflexion(P>0.05).The incidences of hypotension and bradycardia and the total incidence of adverse anesthetic reactions in the observation group were lower than those in the control group(P<0.05).The onset time of anesthesia in the observation group was shorter than that in the control group,while the duration of analgesia in the observation group was longer than that in the control group(P<0.05).Conclusion The combined spinal and epidural anesthesia with ropivacaine combined with sufentanil for cesarean section is definitely effective,which can take effect quickly,stabilize intraoperative hemodynamics,reduce adverse anesthetic reactions as well as achieve better analgesic effect.Therefore,it is worthy of promotion.