0.5%盐酸罗哌卡因复合芬太尼腰麻在剖宫产术中的临床应用效果

目的:探讨0.5%盐酸罗哌卡因复合芬太尼腰麻在剖宫产术中临床应用效果。方法:选取自2015年01月~2015年05月择期在我院行剖宫产的产妇70例,随机分为观察组和对照组,每组35例。对照组采用0.5%盐酸罗哌卡因进行腰麻,观察组采用0.5%盐酸罗哌卡因复合芬太尼进行腰麻。比较两组的麻醉效果及产妇麻醉指标,记录两组麻醉前后血压及心率变化,并对比两组新生儿出生后1、5、10 min的Apgar评分。结果:观察组麻醉优良率为97.14%,明显高于对照组的85.71%(P0.05)。两组麻醉后30 min血压、心率与麻醉前相比,差异具有统计学意义(P0.05),且两组间比较差异具有统计学意义(P0.05)。观察组痛觉阻滞起效时间、痛觉恢复时间、运动阻滞起效时间、运动恢复时间与对照组相比,差异具有统计学意义(P0.05);观察组新生儿出生后1、5、10min Apgar评分均明显高于对照组(P0.05)。结论:0.5%盐酸罗哌卡因复合芬太尼腰麻应用于剖宫产术,能有效提升麻醉效果,麻醉阻滞起效快,持续时间长,有利于改善新生儿结局,具有临床推广意义。

Clinical Effect of 0.5%Ropivacaine Hydrochloride Combined with Fentanyl for Spinal Anesthesia in Intraoperative Cesarean Section

Objective:To discuss the clinical effect of 0.5%ropivacaine hydrochloride combined with fentanyl for spinal anesthesia in intraoperative cesarean section.Methods:Selected 70 puerperants had planned to underwent elective cesarean section in our hospital from January 2015 to May 2015, they were randomly divided into observation group and control group, 35 cases in each group. The control group was treated with spinal anesthesia by 0.5%ropivacaine hydrochloride, and the observation group was treated with spinal anesthesia by 0.5% ropivacaine hydrochloride combined with fentanyl. Compared the anesthesia effect and maternal anesthesia indexes of two groups, and recorded the blood pressure and change of heart rate in two groups before and 30min after anesthesia, then compared the neonatal Apgar scores in the two groups 1, 5, 10 min after birth.Results:The excellent and good rate of anesthesia in the observation group was 97.14%, significantly higher than 85.71%in the control group(P<0.05); The blood pressure, heart rate at 30 minutes after anesthesia were compared with that before anesthesia, the differences were statistically significant (P<0.05); and the differences between the two groups were statistically significant (P<0.05); The onset time of pain block, pain recovery time, onset time of motion block, motion recovery time were compared between the observation group and the control group, the differences were statistically significant(P<0.05); Neonatal Apgar scores in the observation group were significantly higher than those in the control group 1, 5, 10 min after birth respectively( P<0.05).Conclusion:The 0.5%ropivacaine hydrochloride combined with fentanyl for spinal anesthesia in cesarean section, can effectively improve the anesthetic effect, and anesthesia block has rapid onset and long duration, which is beneficial to improve neonatal outcome and have clinical significance.