小剂量罗哌卡因复合芬太尼腰麻用于妊高征病人剖宫产术的临床观察

【摘要】目的：探讨小剂量罗哌卡因复合芬太尼用于蛛网膜下腔神经阻滞（腰麻）在妊高征病人剖宫产术中应用的可行性和效果。方法：拟行剖宫产手术的妊高征患者80例，随机分为A、B两组，每组40例，A组患者在小剂量甲磺酸罗哌卡因复合芬太尼腰麻下行剖宫产术，B组患者在硬膜外麻醉下行剖宫产术。结果：、A、B两组病人比较术中麻醉效果、术后恶心、呕吐、腰痛、头痛等不良反应的发生率无显著差异（P＞0.05）。发现A组病人从麻醉开始术中发生低血压的例数（D）、到手术开始时间（T）、新生儿娩出后3min Apgar评分均少于B组（P＜0.05）。结论：小剂量罗哌卡因复合芬太尼腰麻在妊高征病人剖宫产术中不仅比单纯硬膜外麻阻滞完善，而且可以有效缩短麻醉诱导到手术开始时间，低血压及不良反应发生率无明显差异，该方法安全可行。

The clinical observation of a small dose of Ropivacaine combined with fentanyl in spinal anesthesia for Pregnancy hypertension syndrome patients of Cesarean Section

Abstract Objective: To discuss clinical efficacy and safety of low dose fentanyl added to ropivacaine in subarachnoid block for pregnancy hypertension syndrome patients of cesarean section. Methods: Eighty pregnancy hypertension syndrome patients were randomly allocated to two groups of A、B，with 40 cases for each group. The patients of group A received spinal anesthesia with small dose of ropivacaine combined with fentanyl. The patients of group B received epidural anesthesia. Results: The number of hypotension(D)、apgar score after delivery of the neonate 3min and the adverse reaction rate of postoperative nausea, vomiting, back pain, headaches have no significant differences in two groups(P＞0.05). The score of anesthesia effect and the time from the beginning of anesthesia to the operation start ( T )of group A were all less than group B ( P < 0.05 ). Conclusion: In this clinical observation, not only the anesthesia effect of small dose of ropivacaine combined with fentanyl for spinal anesthesia in pregnancy hypertension syndrome patient during cesarean section is better than epidural anesthesia block, but also the time of anesthesia begain to the operation start can effectively shorten, and the adverse reactions of hypotension have no obvious difference, so, this method is feasible and safe.