不同剂量盐酸罗哌卡因腰硬联合麻醉在剖宫产手术中的应用研究

Application of different doses of ropivacaine hydrochloride combined with epidural anesthesia in cesarean section operation

目的探讨不同剂量盐酸罗哌卡因腰硬联合麻醉在剖宫产手术中的应用效果。方法选取100名经剖宫产手术分娩的产妇,根据随机数字表法分为两组,各50名。所有产妇剖宫产手术中均实施腰硬联合麻醉,对照组予以2ml0.5%盐酸罗哌卡因,试验组予以1.5ml0.5%盐酸罗哌卡因。比较两组麻醉质量及血流动力学指标。结果两组运动阻滞起效时间、感觉阻滞起效时间以及麻醉平面固定时间对比,差异无统计学意义(P>0.05)。麻醉后10min至手术结束时,两组平均动脉压、心率水平有不同幅度波动,试验组平均动脉压、心率水平幅度显著小于对照组(P<0.05)。结论对于剖宫产手术产妇在腰硬联合麻醉时应选用小剂量盐酸罗哌卡因,血流动力学的波动相对较小,维持麻醉质量更理想。

Objective To investigate the effect of different doses of ropivacaine hydrochloride on combined epidural anesthesia in cesarean section operation.Methods 100 women who delivered by cesarean section were divided into two groups with 50 women in each group according to random number table method.All women were given combined epidural anesthesia during cesarean section.The control group was given 2 ml ropivacaine hydrochloride and the experimental group was given 1.5 ml Ropivacaine hydrochloride.The quality of anesthesia and hemodynamics were compared between the two groups.Results There was no significant difference in motor block onset time,sensory block onset time and anesthesia plane fixation time between the two groups(P>0.05).From 10 min after anesthesia to the end of operation,the mean arterial pressure and heart rate of the two groups had different amplitude fluctuations,and the mean arterial pressure and heart rate of the experimental group were significantly lower than that of the control group(P<0.05).Conclusion Low dose ropivacaine hydrochloride should be selected for the combination of lumbar and epidural anesthesia in women undergoing cesarean section.The hemodynamic fluctuation is relatively small,and the quality of anesthesia is better.