不同剂量罗哌卡因腰硬联合麻醉对剖宫产产妇麻醉效果及术中血流动力学指标的影响

Effects of Combined Spinal-Epidural Anesthesia with Different Doses of Ropivacaine on Anesthesia Effect and Hemodynamic Indexes During Cesarean Section

目的本研究探讨了在不同剂量的罗哌卡因腰硬麻醉条件下,对剖宫产产妇麻醉效果和血流动力学参数的具体影响。方法在本项研究中,纳入2023年1月至2023年12月仙游县妇幼保健院收治的260例剖宫产产妇。通过随机数字表法分为两组,即低剂量组和高剂量组,每组130例。高剂量组采用1.0%的罗哌卡因1.8 ml进行腰硬联合麻醉,低剂量组采用1.0%的罗哌卡因1.5 ml进行腰硬联合麻醉。在围手术期内对两组数据进行了比对,分别包括手术时间、娩出时间、麻醉剂量、输液量和产后出血量、麻醉的成效、血液动力学相关指标如舒张压(DBP)、收缩压(SBP)与平均动脉压(MAP)以及不良反应总发生率。结果与相较于高剂量组,低剂量组在手术时间、娩出时间、麻醉剂量、输液量以及产后出血量方面差异无统计学意义(P>0.05)。两组麻醉优良率差异无统计学意义(P>0.05)。两组DBP、SBP、MAP水平麻醉前到麻醉后15 min呈下降趋势,麻醉后15 min到苏醒后15 min呈上升趋势(P<0.05);与高剂量组比较,低剂量组麻醉后15 min、苏醒后15 min各指标水平较高(P<0.05)。低剂量组的不良反应发生率低于高剂量组(P<0.05)。结论与高剂量组比较,低剂量罗哌卡因腰硬联合麻醉用于剖宫产产妇可获得较好的麻醉效果,不会影响术中血流动力学指标,且安全性更高。

Objective In this study,the specific effects of different doses of ropivacaine on anesthesia effect and hemodynamic parameters of cesarean section women were discussed.Methods In this study,260 cases of cesarean section in Xianyou Maternal and Child Health Hospital from January 2023 to December 2023 were included.They were randomly divided into two groups,namely,low-dose group and high-dose group,with 130 cases in each group.The high-dose group was given 1.0%ropivacaine 1.8 ml for combined spinal-epidural anesthesia,and the low-dose group was given 1.0%ropivacaine 1.5 ml for combined spinal-epidural anesthesia.During the perioperative period,the data of the two groups were compared,including operation time,delivery time,anesthesia dosage,infusion volume and postpartum hemorrhage volume,anesthesia effect,hemodynamic indexes such as diastolic blood pressure(DBP),systolic blood pressure(SBP)and mean arterial pressure(MAP),and the total incidence of adverse reactions.Results Compared with the high-dose group,the low-dose group had no significant differences in operation time,delivery time,anesthesia dose,infusion volume and postpartum blood loss(P>0.05).There was no significant difference between the two groups(P>0.05).The levels of DBP,SBP and MAP in both groups decreased from before anesthesia to 15 min after anesthesia,and increased from 15 min after anesthesia to 15 min after recovery(P<0.05).Compared with the high-dose group,the levels of indexes in the low-dose group were higher 15 min after anesthesia and 15 min after recovery(P<0.05).The incidence of adverse reactions in low dose group was lower than that in high dose group(P<0.05).Conclusions Compared with the high-dose group,low-dose ropivacaine combined with spinal-epidural anesthesia can achieve better anesthesia effect for cesarean section women,and it will not affect the hemodynamic indexes during operation,and it is safer.