罗哌卡因复合舒芬太尼不同剂量硬膜外麻醉在足月初产妇剖宫产术中的应用

Application of Ropivacaine Combined With Sufentanil in Different Doses of Epidural Anesthesia in Full-Term Primiparas Undergoing Cesarean Section

目的探讨罗哌卡因复合舒芬太尼不同剂量硬膜外麻醉在足月初产妇剖宫产术中的应用效果。方法选择126例剖宫产产妇,按随机对照原则分为三组,各42例。低剂量组采用0.2μg/mL舒芬太尼,中剂量组采用0.4μg/mL,高剂量组采用0.6μg/mL,均复合0.1%罗哌卡因。比较三组血流动力学[收缩压(SBP)、舒张压(DBP)、心率(HR)]。结果切皮时,三组患者SBP、DBP较麻醉前降低,HR较麻醉前升高,给药15min三组SBP、DBP、HR均较切皮时降低,但在术毕时三组SBP、DBP、HR较给药15min升高,且中剂量组切皮时、手术结束时的SBP、DBP高于低剂量组、高剂量组,HR低于低剂量组、高剂量组,三组组间、时点、组间时点交互比较,差异均有统计学意义(P<0.05);中剂量组感觉阻滞起效时间短于低剂量组,长于高剂量组,差异有统计学意义(P<0.05)。结论0.1%罗哌卡因复合0.4μg/mL舒芬太尼对剖宫产患者血流动力学影响较小,感觉阻滞起效快。

Objective To investigate the application effect of ropivacaine combined with sufentanil in different doses of epidural anesthesia in full-term primiparas undergoing cesarean section.Methods 126 cases of cesarean section women were randomly divided into three groups,42 cases in each group.0.2μg/ml sufentanil was used in the low-dose group,0.4μg/ml in the medium dose group,and 0.6μg/ml in the high-dose group,all of which were combined with 0.1% ropivacaine.Hemodynamics(SBP,DBP,HR)were compared among the three groups.Results SBP and DBP of the three groups were lower than those before anesthesia,while HR was higher than that before anesthesia SBP,DBP and HR were lower than those at skin incision,but SBP,DBP and HR in three groups were higher than those in 15 min after operation,and SBP and DBP at skin incision and at the end of operation in middle dose group were higher than those in low-dose group and high-dose group,while HR was lower than those in low-dose group and high-dose group.There were significant differences among three groups,time points and time points between groups(P<0.05);sensory block occurred in middle dose group.Conclusion 0.1% ropivacaine combined with 0.4μg/ml sufentanil has little effect on hemodynamics of patients undergoing cesarean section,and the onset of sensory block is fast.