小剂量罗哌卡因蛛网膜下腔麻醉在剖宫产中的应用及患者疼痛程度、并发症情况分析

Application of low dose ropivacaine subarachnoid anesthesia in cesarean section and analysis of pain degree and complications

目的探究小剂量罗哌卡因蛛网膜下腔麻醉在剖宫产中的应用及对患者疼痛程度、并发症发生率影响。方法选濮阳市妇幼保健院妇产科2020年1月-2022年5月期间96例足月剖宫产产妇,均应用罗哌卡因蛛网膜下腔麻醉,以随机数字表法分为A组(32例,1 mL 0.75%罗哌卡因)、B组(32例,1.5 mL 0.75%罗哌卡因)、C组(32例,2 mL 0.75%罗哌卡因),比较三组麻醉效果及不良反应。结果麻醉前、麻醉后10 min时三组平均动脉压(MAP)、心率(HR)水平相近,三组麻醉起效时间、达到阻滞平面时间、痛觉恢复时间水平及术后不同时间三组疼痛视觉模拟法(VAS)评分均相近(P>0.05);C组麻黄碱使用率为18.75%,较A组(3.13%)、B组(3.13%)高,C组术后并发症发生率为21.88%,较A组(3.13%)高(P>0.05)。结论剖宫产产妇罗哌卡因蛛网膜下腔麻醉中,0.75%罗哌卡因用药剂量1 mL、1.5 mL、2 mL在麻醉后血流动力学指标、麻醉效果、术后不同时间疼痛感受中效果相近,且1 mL 0.75%罗哌卡因可减少麻黄碱使用率,并降低并发症发生率。

Objective To explore the application of low dose ropivacaine subarachnoid anesthesia in cesarean section and its effect on the pain degree and incidence of complications in patients.Methods A total of 96 full-term cesarean section women from the Obstetrics and Gynecology Department of Puyang Maternal and Child Health Hospital from January 2020 to May 2022 were selected.All of them received subarachnoid anesthesia with ropivacaine.They were randomly divided into group A(32 cases,1mL 0.75% ropivacaine),group B(32 cases,1.5mL 0.75% ropivacaine),and group C(32 cases,2mL 0.75% ropivacaine).The anesthesia effects and adverse reactions of three groups were compared.Results The mean arterial pressure(MAP)and heart rate(HR)levels were similar in three groups before anesthesia and 10 minutes after anesthesia.The onset time of anesthesia,the time to reach the blocking level,the time of pain recovery,and VAS scores of the three groups at different times after surgery were similar(P>0.05).The usage rate of ephedrine in group C was 18.75%,which was higher than that in group A(3.13%)and in group B(3.13%).The incidence of postoperative complications in group C was 21.88%,which was higher than that in group A(3.13%)(P>0.05).Conclusion For patients undergoing cesarean section and subarachnoid anesthesia,the different dosage of 0.75%ropivacaine,1mL,1.5mL,and 2mL,has similar effects on postoperative hemodynamic indicators,anesthesia effects,and pain perception at different times.1mL of 0.75%ropivacaine can reduce the use of ephedrine and the incidence of complications.