不同浓度的罗哌卡因经蛛网膜下腔阻滞在剖宫产手术麻醉中的临床研究
投稿时间:2010-03-14    点此下载全文
引用本文:姚向国,贾俊香.不同浓度的罗哌卡因经蛛网膜下腔阻滞在剖宫产手术麻醉中的临床研究[J].医学研究杂志,2010,39(9):69-71
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作者单位
姚向国 福建省厦门市妇幼保健院麻醉科 
贾俊香 福建省厦门市妇幼保健院麻醉科 
基金项目:福建省厦门市科技局资助项目(3502820084025)
中文摘要:目的探讨不同浓度的罗哌卡因经蛛网膜下腔阻滞在剖宫产手术中的临床效果。方法选择择期行剖宫产手术孕足月单胎产妇90例,ASA分级Ⅰ~Ⅱ级,每组30例,随机分成3组。Ⅰ组,经蛛网膜下腔注入0.5%罗哌卡因2.5ml;Ⅱ组,经蛛网膜下腔注入0.375%罗哌卡因2.5ml;Ⅲ组,经蛛网膜下腔注入0.25%罗哌卡因2.5ml;观察注药后患者血压、心率变化、记录麻醉起效时间、最高感觉阻滞平面、达最高感觉平面的时间、最大运动阻滞评分、达最大运动阻滞时间、麻醉效果评价、术中不良反应(恶心、呕吐、低血压、寒战)、新生儿1、5min Apger评分。结果①3组患者BP在麻醉后5、10min时间点较麻醉前有所降低,其中组内比较Ⅰ(5、10min)、Ⅱ(5min)与麻醉前比较有统计学意义(P<0.05);组间比较在5、10minⅠ、Ⅲ有统计学意义(P<0.05);②感觉起效时间、最高感觉阻滞平面、达最高感觉阻滞平面时间、达最大运动阻滞时间组间比较差异无统计学意义;③运动阻滞Bromage评分:Ⅰ、Ⅱ组高于Ⅲ组(P<0.05),Ⅰ、Ⅱ组间比较差异无统计学意义;④3组麻醉效果评价差异有统计学意义(P<0.05);其中Ⅰ、Ⅱ组优于Ⅲ组(P<0.05);Ⅰ、Ⅱ组间比较差异无统计学意义;⑤术中不良反应3组间比较差异无统计学意义;⑥无新生儿窒息。结论综合循环稳定性与麻醉效果,Ⅱ组优于其他两组,完全可以满足剖宫产手术的要求。
中文关键词:罗哌卡因  蛛网膜下腔阻滞
 
Clinical Research on the Use of Ropivacaine with Different Concentration by Subarachnoid Block in Anesthesia of Uterine-incision Delivery
Abstract:ObjectiveTo investigate clinical effect of ropivacaine with different concentration by subarachnoid block in anesthesia of uterine-incision delivery operation. Methods90 ASA Ⅰ~Ⅱ womem for scheduled cesarean section were randomly divided into three group(n=30 for each) :group Ⅰreceived 2.5ml of 0.5% ropivacaine;group Ⅱ received 2.5ml of 0.375%;group Ⅲ received 2.5ml of 0.25% ropivacaine.Variation of BP and HR after anestha,the onset time of sensory block,max-plane of sensory block and requirement times to max-plane of sensory block,score of max-motor block and time to max-motor block,effect of anesthesia,adverse reaction during operation were obserred and recorded.Results①BP of three groups decreased at 5,10min after anesthesia.Group Ⅰ(5,10min) and Ⅱ(5min)were lower than pro-anaesth(P<0.05), and there was statistical significance at 5,10min between groups Ⅰ and Ⅲ (P<0.05).②There was no statistical significance in onset time of sensory block,max-plane of sensory block,requirement times,time to max-motor block among three groups.③Score of max-motor block of group Ⅰ and Ⅱ was higher than that of group Ⅲ.There was no statistical significance between group Ⅰ and Ⅱ.④Effect of anesthesia of groups Ⅰ and Ⅱ was better than that of group Ⅲ(P<0.05).⑤There was no statistical significance in operation adverse effect.⑥There was no asphyxiation among neonatus.ConclusionAs for cyclical stability and good effect of anesthesia,group Ⅱ is better than group Ⅰ and Ⅲ.It can be used in delivery operation.
keywords:Ropivacaine  Subarachnoid block
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