重比重、等比重和轻比重罗哌卡因在剖宫产手术麻醉应用中的效果

Effects of heavy proportion,equal proportion and light proportion ropivacaine in anesthesia for cesarean section

目的探究与分析重比重、等比重和轻比重罗哌卡因在剖宫产手术麻醉应用中的效果。方法选取苏州市立医院自2020年2月至2022年2月收治的剖宫产产妇90例,采取随机数表法分为重比重组、等比重组、轻比重组,每组各30例,重比重组采用0.5%的盐酸罗哌卡因注射液2 ml+10%葡萄糖1 ml,等比重组采用0.75%的盐酸罗哌卡因注射液2 ml+脑脊液1 ml稀释,轻比重组采用0.75%的盐酸罗哌卡因注射液2 ml+注射用水1 ml,比较三组剖宫产产妇的麻醉效果、麻醉药物起效时间、基础指标变化,同时观察三组剖宫产产妇的不良反应。结果等比重组及重比重组的麻醉总有效率高于轻比重组,差异有统计学意义(P<0.05)。等比重组麻醉阻滞起效时间、运动阻滞起效时间长于轻比重组,短于重比重组,感觉阻滞恢复时间、运动阻滞恢复时间明显短于重比重组,长于轻比重组,差异有统计学意义(P<0.05)。三组麻醉后10 min与麻醉前比较收缩压(SBP)、舒张压(DBP)均较低,心率(HR)升高,等比重组与重比重组比较SBP、DBP较高,等比重组与轻比重组比较SBP、DBP较低,差异有统计学意义(P<0.05)。重比重组分别与等比重组、轻比重组比较,总不良反应发生率较高,差异有统计学意义(P<0.05)。结论等比重罗哌卡因在剖宫产手术麻醉中的应用可获得较好的麻醉效果,缩短了麻醉药物的起效时间,患者的各项生理指标也较为平稳,同时不良反应较少,整体安全性较高。

Objective To investigate and analyze the effects of heavy proportion,equal proportion and light proportion ropivacaine in anesthesia for cesarean section.Methods A total of 90 women admitted to Suzhou Municipal Hospital for cesarean section from February 2020 to February 2022 were selected and divided into a heavy proportion group,an equal proportion group and a light proportion group by random number table method,with 30 women in each group.The heavy proportion group received 2 ml of 0.5%ropivacaine hydrochloride injection+1 ml of 10%glucose injection,the equal proportion group received 2 ml of 0.75%ropivacaine hydrochloride injection+1 ml of cerebrospinal fluid,and the light proportion group received 2 ml of 0.75%ropivacaine hydrochloride injection+1 ml of water for injection.The anesthetic effect,anesthetic drug onset time and changes of basic indexes were compared among the three groups,and the adverse reactions(ARs)in the three groups of women undergoing cesarean section were also observed.Results The overall effective rate of anesthesia in the equal proportion group and the heavy proportion group was significantly higher than that in the light proportion group,with statistically significant difference(P<0.05).The onset time of anesthesia block and motor block in the equal proportion group were significantly longer than that in the light proportion group and shorter than that in the heavy proportion group,and the recovery time of sensory block and motor block in the equal proportion group were significantly shorter than that in the heavy proportion group and longer than that in the light proportion group,with s tatistically significant differences(P<0.05).The systolic blood pressure(SBP)and diastolic blood pressure(DBP)decreased while heart rate(HR)elevated in all the three groups at 10 min after anesthesia,and SBP and DBP in the equal proportion group were higher than those in the heavy proportion group and lower than those in the light proportion group,with statistically significant differences(P<0.05).The total incidence of ARs in the heavy proportion group was higher than that in the equal proportion group and the light proportion group,with statistically significant difference(P<0.05).Conclusion Equal proportion ropivacaine in anesthesia for cesarean section can achieve good anesthetic effect,shorten the onset time of anesthetic drugs,maintain stable physiological indexes,and avoid the increase of ARs during anesthesia,with high safety.