盐酸罗哌卡因联合舒芬太尼对剖宫产患者术后镇痛效果及血流动力学的影响

Effect of Ropivacaine Hydrochloride Combined with Sufentanil on Postoperative Analgesia and Hemodynamics in Patients Undergoing Cesarean Section

目的研究盐酸罗哌卡因联合舒芬太尼对剖宫产患者术后镇痛效果及血流动力学的影响。方法选取2020年10月-2023年3月万载县妇幼保健院行剖宫产的60例产妇为研究对象,采用随机数字表法分为对照组和观察组,各组30例。对照组采用舒芬太尼进行腰-硬联合麻醉,观察组在对照组基础上联合盐酸罗哌卡因进行腰-硬联合麻醉,比较两组产妇术后不同时间点疼痛评分(VAS)、血流动力学[心率(HR)、平均动脉压(MAP)]、舒适程度评分(BCS)及术后首次排气、下床活动时间、不良反应发生情况。结果观察组术后4、12、24 h的VAS评分均低于对照组(P<0.05);观察组分娩后HR低于对照组,MAP高于对照组(P<0.05);观察组术后4、12、24 h的BCS评分均高于对照组(P<0.05);观察组首次排气时间、下床活动时间均短于对照组(P<0.05);观察组不良反应发生率为6.67%,与对照组的10.00%比较,差异无统计学意义(P>0.05)。结论盐酸罗哌卡因联合舒芬太尼可减轻剖宫产患者术后疼痛程度,降低对血流动力学的影响,提高产妇舒适程度,缩短首次排气时间、下床活动时间,且不良反应发生率低,是一种安全、有效的镇痛方式。

Objective To study the effect of ropivacaine hydrochloride combined with sufentanil on postoperative analgesia and hemodynamics in patients undergoing cesarean section.Methods A total of 60 parturients who underwent cesarean section in Wanzai County Maternal and Child Health Hospital from October 2020 to March 2023 were selected as the research objects.They were divided into control group and observation group by random number table method,with 30 parturients in each group.The control group was treated with sufentanil for combined spinal-epidural anesthesia,and the observation group was treated with ropivacaine hydrochloride for combined spinal-epidural anesthesia on the basis of the control group.The pain score(VAS),hemodynamics[heart rate(HR),mean arterial pressure(MAP)],comfort score(BCS)at different time points after operation,the first exhaust after operation,the time of getting out of bed and the occurrence of adverse reactions were compared between the two groups.Results The VAS score of the observation group at 4,12 and 24 h after operation was lower than those of the control group(P<0.05).After delivery,the HR of the observation group was lower than that of the control group,and the MAP was higher than that of the control group(P<0.05).The BCS score of the observation group at 4,12 and 24 h after operation was higher than those of the control group(P<0.05).The first exhaust time and ambulation time in the observation group were shorter than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 6.67%,which was compared with 10.00%in the control group,the difference was not statistically significant(P>0.05).Conclusion Ropivacaine hydrochloride combined with sufentanil can reduce the degree of postoperative pain in patients undergoing cesarean section,reduce the influence of hemodynamics,improve maternal comfort,shorten the first exhaust time and get out of bed activity time,and the incidence of adverse reactions is low.It is a safe and effective analgesic method.