不同剂量罗哌卡因腰-硬联合麻醉对剖腹产孕妇血流动力学及麻醉质量的影响分析

Analysis of the Effects of Different Doses of Ropivacaine Combined Spinal Epidural Anesthesia on Hemodynamics and Anesthesia Quality in Pregnant Women Undergoing Cesarean Section

目的 分析在剖腹产分娩孕妇中采用不同剂量的罗哌卡因腰-硬联合麻醉的效果及其对产妇血液动力学的影响。方法 目的抽样法选取2022年1-12月寿光市人民医院90例剖腹产产妇为研究对象,根据术中罗哌卡因使用剂量不同分为对照组和观察组,各45例。所有孕妇均采取腰-硬联合麻醉方式,对照组给予0.75%罗哌卡因2 mL,观察组给予0.75%罗哌卡因1 mL。对比两组术前、麻醉15 min、分娩后、手术结束后的血流动力学指标及麻醉质量。结果 术前、麻醉15 min时,两组各项血流动力学指标对比,差异无统计学意义(P均>0.05)。观察组分娩后、手术结束后的心率分别为(80.63±10.36)次/min、(80.23±9.52)次/min,均低于对照组的(89.41±11.25)次/min、(86.49±10.25)次/min,差异有统计学意义(t=3.851、3.002,P均<0.05)。观察组分娩后、手术结束后的平均动脉压均高于对照组,差异有统计学意义(P均<0.05)。两组分娩后、手术结束后的血氧饱和度对比,差异无统计学意义(P均>0.05)。观察组的感觉阻滞、麻醉阻滞、麻醉消退时间短于对照组,差异有统计学意义(P均<0.05)。两组麻醉平面维持时间对比,差异无统计学意义(P>0.05)。结论 在剖腹产腰-硬联合麻醉术中,应用小剂量的罗哌卡因可以起到良好的麻醉作用,可以使血液动力学得到稳定,提高麻醉质量,从而改善预后。

Objective To analyze the effects of different doses of ropivacaine combined with spinal epidural anesthe-sia in pregnant women undergoing cesarean section and its impact on maternal hemodynamics.Methods 90 cesarean section parturients from Shouguang People′s Hospital from January to December 2022 were selected as the study ob-jects by target sampling method.According to the different doses of ropivacaine used during surgery,patients were di-vided into a control group and an observation group,with 45 cases in each group.All pregnant women were given lum-bar epidural anesthesia,with the control group receiving 2 mL of 0.75%ropivacaine and the observation group receiv-ing 1 mL of 0.75%ropivacaine.Hemodynamic indicators before surgery,15 minutes of anesthesia,after delivery,and after surgery and anesthesia quality for two groups were compared.Results There was no statistically significant differ-ence in various hemodynamic indicators between the two groups before surgery and at 15 min of anesthesia(all P>0.05).The heart rates of the observation group after delivery and surgery were(80.63±10.36)beats/min and(80.23±9.52)beats/min,respectively,which were lower than(89.41±11.25)beats/min and(86.49±10.25)beats/min of the con-trol group,and the differences were statistically significant(t=3.851,3.002,both P<0.05).The average arterial pres-sure in the observation group after delivery and surgery were higher than those in the control group,and the differ-ences were statistically significant(both P<0.05).There was no statistically significant difference in blood oxygen satu-ration between the two groups after delivery and surgery(both P>0.05).The sensory blockade,anesthesia blockade,and anesthesia resolution time of the observation group were shorter than those of the control group,and the differ-ences were statistically significant(all P<0.05).There was no statistically significant difference in the duration of anes-thesia plane maintenance between the two groups(both P>0.05).Conclusion In the lumbar epidural anesthesia for ce-sarean section,the use of low-dose ropivacaine can have a good anesthetic effect,stabilize hemodynamics,improve the quality of anesthesia,thereby improving the prognosis.