不同浓度罗哌卡因用于蛛网膜下腔阻滞在剖宫产手术中的效果分析

目的:探讨不同浓度罗哌卡因用于蛛网膜下腔阻滞在剖宫产手术中的效果。方法:选择2015年7月到2017年12月在本院进行剖宫产的初产妇89例作为研究对象,根据随机数字表法分为观察组44例与对照组45例,两组都给予经蛛网膜下腔阻滞麻醉。观察组注入罗哌卡因15 mg,对照组注入罗哌卡因17.5 mg。比较两组麻醉开始前(T0)、麻醉开始后2 min(T1)、10 min(T2)的呼吸频率(Respiration Rate,RR)和心率(Heart Rate,HR),两组的最高感觉阻滞时间、最高阻滞平面、感觉阻滞起效时间,术后2 h、4 h与24 h的VAS疼痛评分,产妇不良反应情况的发生情况并进行新生儿评价。结果:所有产妇在不同时间点的呼吸频率和心率均正常波动,组间与组内对比差异均无统计学意义(P0.05)。两组的感觉阻滞起效时间、最高阻滞平面、最高感觉阻滞时间对比差异无统计学意义(P0.05)。两组术后2 h、4 h与24 h的疼痛评分比较差异无统计学意义(P0.05)。所有新生儿都顺利分娩,1 min和5min Apgar评分都为9-10分;观察组产妇的不良反应发生率为4.5%,显著低于对照组的27.3%(P0.05)。结论:剖宫产手术经蛛网膜下腔阻滞中应用15 mg罗哌卡因也能保持产妇循环功能稳定,具有良好的镇痛与阻滞效果,且安全性更高。

Analysis of the Different Ropivacaine Concentrations Effects in Subarachnoid Block for the Cesarean Section

ABSTRACT Objective: To investigate the effect of different concentrations of ropivacaine for subarachnoid block in cesarean section. Methods: 89 cases of primiparas who underwent cesarean section in our hospital from July 2015 to December 2017 were selected as subjects. They were divided into observation group (44 cases) and control group (45 cases) according to the random number table method. Both groups of women were given anesthesia via subarachnoid block. The observation group received 15 mg of ropivacaine and the control group received 17.5 mg of ropivacaine. The respiratory rate (RR) and heart rate (HR) of the two groups of women before the start of anesthesia (T0), 2 min (T1), and 10 min (T2) after anesthesia were compared. The highest sensory block time, the highest block plane, the onset time of sensory block, the VAS pain score at 2 h, 4 h, and 24 h after surgery and maternal adverse reactions were recorded. The newborn is evaluated. Results: The respiratory rate and heart rate of all women at normal time fluctuated normally, and there was no significant difference between the groups and in the group(P>0.05). There was no significant difference in the onset time of sensory block, the highest block plane, the highest sensory block time between the two groups(P>0.05). There was no significant difference in pain scores between the two groups at 2 h, 4 h and 24 h after surgery(P>0.05). All newborns were delivered successfully. The Apgar scores were 9-10 points at 1 min and 5 min. The incidence of adverse reactions in the observation group was 4.5%, which was significantly lower than that in the control group (27.3%)(P<0.05). Conclusion: 15 mg ropivacaine can also maintain stable maternal circulation during anesthesia with cesarean section. It has good analgesic and retarding effects, and its safety is higher.