不同浓度舒芬太尼复合小剂量罗哌卡因腰硬联合麻醉在剖宫产术中的应用

目的观察不同浓度舒芬太尼复合小剂量罗哌卡因腰硬联合麻醉应用于分娩镇痛的效果。方法将258例采用腰硬联合阻滞行剖宫产术的患者随机分为A、B、C三组，每组各86例，分别给予O．2、0．4、0．6μg／mL舒芬太尼复合0．1％盐酸罗哌卡因。结果与A组比较，B、C组感觉阻滞起效时间明显缩短，感觉阻滞时间明显延长（P〈0．05）；而B组与C组比较差异无统计学意义（P〉0．05）。三组患者运动阻滞起效时间和运动作用时间比较；差异均无统计学意义（P〉0．05）。B、C组术后2、6、12hVAS评分显著低于A组（P〈0．05），而B组与C组VAS评分比较差异无统计学意义（P〉0．05）。三组术后24hVAS评分比较差异均无统计学意义（P〉0．05）。A组和B组不良反应的发生率分别为7．0％、9．3％，显著低于C组（20．9％），差异有统计学意义（P〈0．05）。结论0．4μg／mL舒芬太尼复合0．1％盐酸罗哌卡因腰硬联合麻醉应用于分娩镇痛安全有效．可增强感觉阻滞作用，缓解术后早期疼痛。

Application study of combined spinal-epidural anesthesia by different concentration of Sufentanil combined with small-dose Ropivacaine in ce- sarean section

Objective To observe the effect of different concentration of Sufentanil combined with small-dose ltoplva- caine in combined spinal-epidural anesthesia for labor analgesia. Methods 258 patients for cesarean section per- formed by combined spinal-epidural anesthesia were randomly divided into three groups including group A, group B and group C, with 86 cases in each group, they were given 0.1% Ropivacaine combined with 0.2, 0.4, 0.6 μg/mL Sufentanil separately. Results Compared with group A, the onset of sensory block was remarkably decreased, and the duration was significantly increased in group B and group C （P 〈 0.05）, while there was no significant difference be- tween group B and group C （P 〉 0.05）. There were no significant differences in the onset and duration of motor block among the three groups （P 〉 0.05）. The VAS scores after cesarean section for 2, 6, 12 h in group B and group C were significantly lower than those in group A （P 〈 0.05）, while there was no significant difference between group B and group C （P 〉 0.05）. The VAS scores after cesarean section for 24 h among three groups were not significantly different （P 〈 0.05）. The rate of side effect in group A and group B （7.0%, 9.3%） was significantly lower than that in group C （20.9%） （P 〈 0.05）. Conclusion The concentration of 0.4 μg/mL Sufentanil ＋ 0.1%＇ Ropivacaine in postoperative anal- gesia after cesarean section is safe and effective, which can enhance the effect of sensory block, and can contribute to relief early pain after operation.