小剂量盐酸罗哌卡因注射液复合舒芬太尼蛛网膜下腔麻醉用于剖宫产的临床研究

目的探讨小剂量罗哌卡因复合舒芬太尼蛛网膜下腔麻醉在剖宫产中的效果和安全性。方法将我院128例行剖宫产的产妇随机分为治疗组和对照组。治疗组65例,采用小剂量盐酸罗哌卡因注射液复合舒芬太尼蛛网膜下腔麻醉;对照组63例,仅使用罗哌卡因。对比两组产妇的术后心率、血压变化、疼痛评分、新生儿Apgar评分,观察感觉运动神经阻滞情况。结果治疗组患者麻醉30 min后血压、心率控制情况均明显优于对照组,差异有统计学意义(P<0.05);两组患者感觉阻滞时间、运动阻滞时间、感觉阻滞起效时间比较差异有统计学意义(P<0.05);治疗组术后疼痛评分为(4.4±1.7)分,对照组为(7.8±1.4)分,两组比较差异有统计学意义(P<0.05);治疗组新生儿Apgar评分优于对照组(9.7±0.6)vs.(7.7±0.7)],差异有统计学意义(P<0.05)。结论小剂量盐酸罗哌卡因注射液联合舒芬太尼蛛网膜下腔麻醉用于剖宫产,可以增强麻醉效果,减少麻醉起效时间,延长感觉阻滞作用时间,可更好地控制产妇的心率和血压,值得临床推广。

Clinical observation of small dose of ropivacaine combined with sufentanil subarachnoid anesthesia for cesarean section

Objective To explore the effect and safety of small dose ropivacaine combined with sufentanil on subarachnoid anesthesia in cesarean section. Methods 128 cases of cesarean section in our hospital were randomly divided into treatment group and control group. Patients in treatment group（ n = 65 ）were treated with small dose of ropivacaine combined with sufentanil subarachnoid anesthesia, patients in control group （ n = 63 ） were given ropivacaine. The changes of postoperative heart rate and blood pressure, and the scores of pain and neonatal Apgar were recorded, the sensory and motor nerve block was observed. Results The blood pressure and heart rate control at 30 min after anesthesia in treatment group was significantly better than that of control group（ P 〈 0.05 ）. There were significant differences in the sensory block time, motor block time and sensory block onset time between the two groups （ P 〈 0.05 ）. The postoperative pain scores of treatment group and control group were（4.4 ± 1.7 ） and（7.8 ± 1.4） ,there were significant differences between the two groups （ P 〈 0. 05 ）. The neonatal Apgar scores of treatment group and control group were 9.7± 0.6 and 7.7 ± 0.7, there were significant differences between the two groups （ P 〈 0. 05 ）. Conclusion Small dose of ropivacaine combined with sufentanil subarachnoid anesthesia for cesarean section, can enhance the anesthetic effect ,reduce the onset time of anesthesia ,prolong the action time of sensory block, better control the heart rate and blood pressure, it is worthy of clinical promotion.