罗哌卡因蛛网膜下腔阻滞在剖宫产术中的应用

目的观察不同浓度罗哌卡因用于蛛网膜下腔阻滞剖宫产术的麻醉效能、母婴安全和相关不良反应。方法采用随机双盲法，将60例剖宫产手术的足月单胎产妇均分为三组：0．5％罗哌卡因组（L1组），0．75％罗哌卡因组（L2组）和0．5％布比卡因组（C组）。记录蛛网膜下腔阻滞后产妇的感觉阻滞和运动阻滞的起效和持续时间、麻醉质量评价、恶心呕吐等不良反应及术中HR、BP、SpO2和新生儿1min和5min Apgar评分。结果L1和L2组比C组起效慢，阻滞平面低，平面固定时间长。L2组感觉阻滞时间比L1组和C组长。L2组和C组肌松评分优于L1组。运动神经阻滞改良Bromage评分，L1组〈k组〈C组（P〈0．05）。三组术中低血压及其他不良反应发生率差异无统计学意义。结论0．75％罗哌卡因用于蛛网膜下腔阻滞剖宫产时，其麻醉效能弱于0．5％布比卡因，而强于0．5％罗哌卡因，三者均具有较好的安全性。

The application of ropivacaine subarachnoid block in Cesarean section

Objective To compare the anesthesia efficiency and safety of different concentrations of ropivacaine with bupivacain spinal anesthesia.Methods Sixty full-tern gravitas undergoing Cesarean section were divided into three groups with twenty cases each:0.5% ropivacaine group(L1), 0.75% ropivacaine group(L2),and 0.5% bupivacaine group(C). The onset and duration of sensory and motor block, adversre reactions, HR,BP,SpO2 during operation and Apgar score of neonates at 1 min and 5 min were recorded and compared. Results There was no significant difference in the three groups for the common conditions of pregnant women and the apart score of neon ales and tie incidence of adverse reactions. The onset and duration tine of sensory block and modifier bromide score(MBS)of motor block were different in three groups. The evaluation of intensity of pain and muscle relaxation was significant doffing. Conclusion The aesthesia efficiency of 0.75% ropivacaine is litter than 0.5% ropiacaine,but stronger than 0.5% bupivacaine.Three have the good safety.