等比重罗哌卡因腰硬联合椎管内麻醉减少剖宫产术仰卧位低血压综合征的临床观察

目的研究等比重罗哌卡因腰硬联合椎管内麻醉预防剖宫产术仰卧位低血压综合征（SHS）的效果。方法选择在腰硬联合椎管内麻醉下行剖宫产术的待产妇150例，ASA1～2级。随机分为常规罗哌卡因组（A组），等比重罗哌卡因组（B组），每组75例。A组蛛网膜下腔注入15mg常规罗哌卡因；B组蛛网膜下腔注A．15mg等比重罗哌卡因。比较两组术中镇痛的评价、术中肌肉松弛的评价及发生SHS的情况。结果两组产妇术中镇痛的评价及肌肉松弛的评价比较，差异无统计学意义（P〉0．05）；两组发生SHS的情况比较，差异有统计学意义（P〈0．05），B组比A组发生率更低，但是B组和A组的发生率同样偏高。结论等比重罗哌卡因腰硬联合椎管内麻醉能够有效减少剖宫产术SHS的发生。

Improvement of Supine Hypotensive Syndrome following Cesarean Section with Isobaric Ropivacaine Combined Spinal-epidural Anesthesia

Objective To investigate the results of isobaric ropivacaine combined spinal-epidural anesthesia（CSEA） prevention of supine hypotensive syndrome（SHS） following cesarean section. Methods 150 cases of pregnant women with caesarean section were performed CSEA. The ASA were 1-2 grade. All cases were randomized into convertional ropivacaine group（group A, n=75 cases） and isobaric ropivacaine group（group B, n=75 cases）. 15mg conventional ropivacaine and isobaric ropivacaine were injected into Group A and Group B, respectively. The incidence of SHS and intraoperative muscle relaxation effect and analgesia effect were analyzed between two groups. Results There were no significant difference in intraoperative muscle relaxation effect and analgesia effect between two groups （ P〉0.05）.The incidence of SHS was significantly lower in Group B than one in Group A（P〈0.05）. However, two groups showed a higher incidence of SHS. Conclusion The isobaric ropivacaine CSEA can effectively decrease the incidence of SHS following cesarean section.