不同剂量盐酸罗哌卡因在剖宫产产妇中的应用效果及对母儿的影响

Application effect of different doses of ropivacaine in cesarean section and its influence on mother and fetus

目的 :探讨不同剂量盐酸罗哌卡因在剖宫产产妇中的应用效果及对母儿的影响。方法 :选择2016年8月～2017年7月于我院行剖宫产手术的产妇150例,根据盐酸罗哌卡因应用剂量将其分为3组,分别为R10组50例(应用10mg的1%盐酸罗哌卡因)、R12组50例(应用12 mg的1%盐酸罗哌卡因)与R14组50例(应用14mg的1%盐酸罗哌卡因)。观察对比三组产妇的感觉阻滞与运动阻滞指标、麻醉效果、麻醉相关不良反应、三组新生儿脐带血气分析与1minApgar评分情况。结果 :感觉阻滞指标中,R14组与R12组维持时间高于R10组,其中R14组高于R12组;R14组与R12组最高阻滞平面低于R10组,其中R14组低于R12组。运动阻滞指标中,R14组与R12起效时间、完善时间低于R12组,维持时间高于R12组。R14组与R12组麻醉Ⅳ级的发生率均高于R10组,但R14组与R12组间对比差异无统计学意义。R14组产妇低血压、恶心呕吐、胸闷的发生率均高于R10组与R12组。三组新生儿脐带血气分析与1minApgar评分对比中差异无统计学意义。结论 :综合考虑麻醉镇痛效果及对母儿的影响方面,12mg剂量的盐酸罗哌卡因的在剖宫产产妇中的应用效果更为理想,具更麻醉起效快、效果满意、不良反应少等优势,适于临床应用。

Objective To investigate the effect of different doses of ropivacaine in cesarean section and its influence on mother and fetus. Methods The August 2016 ～2017 year in July in our hospital cesarean section in 150 cases, according to the dose of ropivacaine will be divided into 3 groups, respectively 50 cases in group R10(Application of 10 ml 1% ropivacaine), group R12 50 cases(12 ml 1% ropivacaine) and group R14(50 cases with 14 ml 1% ropivacaine). The sensory block and motor block index, anesthetic effect, anesthesia related adverse reactions, neonatal umbilical cord blood gas analysis and 1 min Apgar score of three groups were observed and compared between the three groups. Results The sensory block index in R14 group and R12 group was longer than that of R10 group, the R14 group than in R12 group; R14 group and R12 group was the highest block level lower than that of R10 group, the R14 group than in R12 group. In motor block index, the onset time and perfect time of group R14 and R12 were lower than those of group R12, and the duration of maintenance was higher than that of group R12. The incidence of anesthesia grade IV in group R14 and group R12 was higher than that in group R10, but there was no significant difference between group R14 and group R12. The incidence of hypotension, nausea, vomiting and chest tightness in group R14 were higher than those in group R10 and group R12. There was no significant difference between the three groups of umbilical cord blood gas analysis and 1 min Apgar score. Conclusion Considering the analgesic effect and the impact on mother and child, the dose of 12 mg ropivacaine in cesarean section and the application effect is more ideal, more effective and satisfactory anesthesia, adverse reactions and other advantages, suitable for clinical application.