甲磺酸罗哌卡因腰麻——硬膜外麻醉在剖宫产手术中应用

目的:观察甲磺酸罗哌卡因用于腰麻-硬膜外麻醉在剖宫产手术的安全性和可行性。方法:选择在腰硬联合麻醉下行剖宫产术患者60例,ASAⅠ～Ⅱ级,年龄20~35岁,体重60~82.5kg,随机分为A、B两组,各30例。A组用甲磺酸罗哌卡因,B组用盐酸布比卡因,两组均选择L2-4间隙用针内针方法行麻醉,记录感觉、运动神经阻滞情况、生命体征、肌松效果、牵拉反应、新生儿Apgar评分及麻醉并发症发生情况。结果:与B组比较,A组患者感觉和运动神经阻滞起效慢,维持时间短(P0.05);改良Bromage评分:A组与B组比较,小于B组,两组比较有统计学意义(P0.05);A组术中血流动力学波动小于B组(P0.05);两组均未见任何神经系统并发症;两组出生的新生儿1 min、5 minApgar评分均无显著差异。结论:甲磺酸罗哌卡因用于腰麻-硬膜外麻醉在剖宫产术的临床效果显著,对患者血液动力学影响小,运动阻滞程度轻,术后患者能及早活动,对母婴无不良影响,安全有效,值得临床推广。

Application of Ropivacaine Mesylate spinalanesthesia - epidural anesthesia in cesarean section

Objective： To observe surgical safety and feasibility of the ropivacaine mesylate for spinal - epidural anesthesia in cesarean section. Methods ： In the combined spinal-epidural anesthesia for cesarean sec- tion in 60 patients, ASA Ⅰ-Ⅱ grade, age 20-35 years old, weighing 60-82.5kg, The patients were randomly di- vided into A, B two groups, of 30 cases, A group with ropivacaine mesylate, B group with bupivacaine hydrochlo- ride, the two groups were selected L2-4 within the space needle spinal anesthesia needle method of lines, record sensory and motor nerve block conditions, vital signs, muscle relaxant effect, traction reaction, new children Ap- gar score and narcotic complications. Results： B group, A group of sensory and motor nerve block slow onset, short duration （P〉 0.05）, modified Bromage score： A group and B group, the two groups was statistically signifi- cant （P〉 0.05）. A group of hemodynamic fluctuation is less than in group B （P〉 0.05）, any two groups were no neurological complications, two groups of infants born 1 min, 5 min Apgar score were not significantly different. Conclusion： Ropivacaine mesylate for spinal - epidural anesthesia in cesarean section has a significant clinical effect on hemodynamics in patients with small hemodynamics, mild motor block, early postoperative activities, and without adverse effects on mother and child, which is safe and effective, and worthy of promotion.