小剂量罗呱卡因复合舒芬太尼蛛网膜下腔麻醉用于剖宫产的临床观察

目的 观察小剂量罗呱卡因复合舒芬太尼行蛛网膜下腔麻醉用于剖宫产的麻醉效果.方法 将75例美国麻醉医师协会(ASA)分级为Ⅰ～Ⅱ级的剖宫产患者随机分为A、B、C 3组,每组25例.A组:0.75%罗呱卡因15 mg(2 mL);B组:0.75%罗呱卡因10 mg(1.3 mL);C组:0.75%罗呱卡因7.5 mg+舒芬太尼5 μg (0.75%罗呱卡因1.0 mL+舒芬太尼0.1 mL).B、C两组均加10%葡萄糖溶液至2 mL.观察3组给药后平均动脉压(MAP)和心率变化、麻醉效果、新生儿Apgar评分、不良反应发生率及麻黄碱用量.结果 麻醉后A、B两组MAP和心率明显下降(P<0.05),

Small doses of ropivacaine combined with sufentanil spinal anesthesia used for clinical observation of cesarean section

Objective To observe the effects of small doses of ropivacaine combined with sufentanil spinal anesthesia for cesarean section anesthesia.Methods 75 cases of ASAⅠ-Ⅱ class cesarean delivery were randomly divided into A,B,C,three groups,each group of 25 cases.GroupA:0.75% ropivacaine 15 mg(0.75% ropivacaine 2 mL),group B:0.75% ropivacaine 10 mg(0.75% ropivacaine 1.3 mL),group C:0.75% ropivacaine 7.5 mg + sufentanil 5 μg(0.75% ropivacaine 1.0 mL+ sufentanil 0.1 mL).Both B and C groups were added 10% glucose solution to 2 mL.After anesthesia,the hemodynamic changes,the degree of motor block,motor block to maintain time,the highest plane of sensory block,analgesic duration,onset time,neonatal Apgar score,adverse reactions and dosage of ephedrine were observed.Results After anesthesia,the MAP and HR in group A and B were decreased,which were statistically significant compared with the results in group C(P<0.05);and there was significant difference in MAP between group A and group B(P<0.05).After anesthesia,the onset time of sensory block in group C was shorter than in group A and group B(P<0.05);the duration of sensory block in group B was shorter than in group A and group C(P<0.05),while there was no statistically significant difference between the group A and group C(P>0.05);the highest sensory block plane in group B was lower than in group A and group C(P<0.05),while there was no statistically significant difference between group A and group C(P>0.05).The duration of sensory block of motor nerves in group C was shorter than in group A and group B(P<0.05);the bromage score in group C was lower than in group A and group B(P<0.05).The rates of postoperative urinary retention,nausea,vomiting and yellow alkali dosage in group C were significantly lower than group A and group B(P<0.05),There was no significant difference in neonatal Apgar score between the groups(P>0.05).Conclusion Combination of small dose of ropivacaine with sufentanil was an ideal anesthetic for cesarean section,for the exact effects of spinal anesthesia,hemodynamic stability,minimal impact on breathing,as well as fewer adverse reactions.