[1]单会荣,涂莹莹.腰麻下罗哌卡因复合硬膜外不同剂量舒芬太尼用于剖宫产麻醉的临床效果观察[J].医学信息,2021,34(22):106-108.[doi:10.3969/j.issn.1006-1959.2021.22.032]
　SHAN Hui-rong,TU Ying-ying.Clinical Effect of Ropivacaine Combined with Different Doses of Sufentanil in Epidural Anesthesia for Cesarean Section Under Spinal Anesthesia[J].Medical Information,2021,34(22):106-108.[doi:10.3969/j.issn.1006-1959.2021.22.032]
点击复制

腰麻下罗哌卡因复合硬膜外不同剂量舒芬太尼用于剖宫产麻醉的临床效果观察()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年22期
页码:
106-108
栏目:
临床研究
出版日期:
2021-11-15

文章信息/Info

Title:
Clinical Effect of Ropivacaine Combined with Different Doses of Sufentanil in Epidural Anesthesia for Cesarean Section Under Spinal Anesthesia
文章编号:
1006-1959（2021）22-0106-03
作者:
单会荣; 涂莹莹
（高安市妇幼保健院麻醉科1，妇产科2，江西 高安 330800）
Author(s):
SHAN Hui-rong; TU Ying-ying
(Department of Anesthesiology1,Department of Obstetrics and Gynecology2,Gao’an Maternal and Child Health Hospital,Gao’an 330800,Jiangxi,China)
关键词:
腰麻; 罗哌卡因; 硬膜外麻醉; 舒芬太尼; 剖宫产
Keywords:
Spinal anesthesia; Ropivacaine; Epidural anesthesia; Sufentanil; Cesarean section
分类号:
R692
DOI:
10.3969/j.issn.1006-1959.2021.22.032
文献标志码:
A
摘要:
目的 观察腰麻下罗哌卡因复合硬膜外不同剂量舒芬太尼用于剖宫产麻醉的临床效果。方法 选取2019年5月-2021年5月在我院行剖宫产的70例孕妇，随机分为对照组和观察组，各35例。两组均采用腰麻下罗哌卡因复合硬膜外麻醉，对照组硬膜外舒芬太尼剂量为20 μg，观察组硬膜外舒芬太尼剂量为15 μg，比较两组麻醉效果、疼痛（VAS）评分、不同时间段舒张压和收缩压以及心率、运动恢复时间和新生儿Apgar评分、临床不良反应发生情况。结果 两组麻醉优良率、运动恢复时间和新生儿Apgar评分比较，差异无统计学意义（P＞0.05）。两组术后2、6、12 h VAS评分比较，差异无统计学意义（P＞0.05）。麻醉后3 min两组舒张压、收缩压均低于麻醉前，心率高于麻醉前，但观察组舒张压和收缩压高于对照组，心率低于对照组，差异有统计学意义（P＜0.05）。观察组不良反应发生率为8.57%，低于对照组的22.85%，差异有统计学意义（P＜0.05）。结论 腰麻下罗哌卡因复合硬膜外不同剂量舒芬太尼用于剖宫产麻醉，临床效果、镇痛效果基本一致，但是复合硬膜外15 μg舒芬太尼对心率、血压影响较小，且不良反应少，相对具有更优的治疗安全性，更加适用于临床剖宫产麻醉及术后镇痛的合理剂量。
Abstract:
Objective To observe the clinical effect of ropivacaine combined with different doses of sufentanil for cesarean section anesthesia under spinal anesthesia.Methods A total of 70 pregnant women who underwent cesarean section in our hospital from May 2019 to May 2021 were selected as the research objects. They were randomly divided into control group and observation group, with 35 cases in each group. Both groups were treated with ropivacaine combined with epidural anesthesia under spinal anesthesia, the dosage of sufentanil was 20μg in control group and 15μg in observation group. The anesthetic effect, pain (VAS) score, diastolic and systolic blood pressure at different time points, heart rate, exercise recovery time, neonatal Apgar score and clinical adverse reactions were compared between the two groups.Results There was no significant difference in the excellent and good rate of anesthesia, exercise recovery time and neonatal Apgar score between the two groups (P>0.05). There was no significant difference in VAS score between the two groups at 2,6,12 h after operation (P>0.05). At 3 min after anesthesia, the diastolic blood pressure and systolic blood pressure of the two groups were lower than those before anesthesia, and the heart rate was higher than that before anesthesia, but the diastolic blood pressure and systolic blood pressure of the observation group were higher than those of the control group, and the heart rate was lower than that of the control group, the differences were statistically significant (P<0.05). The incidence of adverse reactions in the observation group was 8.57%, which was lower than 22.85% in the control group, and the difference was statistically significant (P<0.05).Conclusion The clinical effect and analgesic effect of ropivacaine combined with different doses of sufentanil in epidural anesthesia for cesarean section are basically the same under spinal anesthesia. However, 15 μg sufentanil in epidural anesthesia has little effect on heart rate and blood pressure, and fewer adverse reactions, which has better therapeutic safety and is more suitable for the reasonable dose of clinical cesarean section anesthesia and postoperative analgesia.

参考文献/References:

[1]方正春.罗哌卡因复合舒芬太尼用于剖宫产麻醉的临床效果[J].临床合理用药杂志,2016,9(2):69-70.[2]杨雪梅.静脉给予右美托咪定对罗哌卡因蛛网膜下腔阻滞效果的影响[J].中国继续医学教育,2016,8(5):53-55.[3]蒙绍广.舒芬太尼复合不同剂量罗哌卡因蛛网膜下腔阻滞麻醉在剖宫产术中麻醉效果[J].吉林医学,2016,37(3):634-636.[4]孙洪涛,栗偲平.罗哌卡因联合舒芬太尼在剖宫产术中临床麻醉效果分析[J].中国现代药物应用,2016,10(11):168-169.[5]陈勤广,王志强,梁蔚云,等.利多卡因复合舒芬太尼硬膜外麻醉在剖宫产术中的应用效果研究[J].齐齐哈尔医学院学报,2016,37(9):1166-1168.[6]李丹,陈琦,康宇,等.硬膜外腔注射氢吗啡酮在剖宫产术后镇痛的临床观察[J].国际麻醉与复苏杂志,2016,32(4):310-312.[7]谭祖英,马杰,侯芳,等.舒芬太尼腰硬联合阻滞麻醉在剖宫产麻醉镇痛中的应用研究[J].中国医药导刊,2016,18(6):607-609.[8]瞿敏,于莉莉,李婧,等.不同体位肱动脉峰流速差值对产妇腰麻后仰卧位低血压综合征的预测作用[J].临床麻醉学杂志,2018,34(4):345-347.[9]蔺杰,白耀武.腰硬联合麻醉在妊娠期高血压疾病患者剖宫产术中的效果及对母婴结局的影响[J].中国临床研究,2017,30(1):104-106.[10]李媚娟,徐琼,李妹燕.分娩疼痛机制与常用分娩镇痛方法[J].国际妇产科学杂志,2018,45(2):125-129.[11]孙德月.潜伏期分娩镇痛对孕妇妊娠结局和新生儿预后影响研究[J].中国妇幼保健,2016,30(30):5295-5296.[12]罗月华.潜伏期行椎管内阻滞麻醉分娩镇痛对孕妇妊娠结局与新生儿预后的影响[J].中国当代医药,2017,24(12):78-80.[13]高华萍,刘文值,李卫.腰-硬联合麻醉剖宫产术中预注去氧肾上腺素与麻黄碱对母婴的影响[J].四川医学,2017,38(4):431-435.[14]孙沛然,刘文立.罗哌卡因与布比卡因腰麻在剖宫产手术中的麻醉效果比较[J].中国处方药,2019,17(9):105-106.[15]李友良,魏智慧,史玉华,等.小剂量低浓度布比卡因复合舒芬太尼腰麻用于剖宫产术的效果[J].河北医药,2017,39(13):1981-1983.[16]涂文劭,郑晓春,陈江湖.罗哌卡因联合舒芬太尼腰麻-硬膜外麻醉在剖宫产手术中的应用效果[J].临床合理用药杂志,2017,10(8):62-63.[17]莫家全,张敏森,黄坚,等.右美托咪啶在剖宫产手术中的效果及对新生儿Apgar的影响[J].中国医药导报,2016,11(24):51-54.[18]亢飞.硬膜外麻醉对初产妇分娩疼痛程度、产程进展及分娩结局的影响[J].现代诊断与治疗,2019,30(3):433-434.[19]魏晓佳,戴晓云,范冰冰,等.剖宫产患者辅用右美托咪定对新生儿的影响[J].江苏医药,2016,40(22):2715-2717.[20]蒋焕伟,徐世元,方曼菁,等.硬膜外罗哌卡因复合舒芬太尼或芬太尼用于潜伏期分娩镇痛[J].临床麻醉学杂志,2016,31(3):221-223.

相似文献/References:

[1]喻僖秦.腰麻前预灌充胶体对产妇及新生儿心肌酶和肌钙蛋白的影响研究[J].医学信息,2018,31(01):79.[doi:10.3969/j.issn.1006-1959.2018.01.028]
　YU Xi-qin.Effect of Prefilled Colloid on Myocardial Enzymes and Troponin in Parturients and Neonates before Lumbar Anesthesia[J].Medical Information,2018,31(22):79.[doi:10.3969/j.issn.1006-1959.2018.01.028]
[2]黄艳东.不同剂量氢吗啡酮用于膝关节置换术后硬膜外镇痛的临床观察[J].医学信息,2018,31(01):85.[doi:10.3969/j.issn.1006-1959.2018.01.030]
　HUANG Yan-dong.Clinical Observation of Epidural Analgesia after Knee Arthroplasty with Different Doses of Hydromorphine[J].Medical Information,2018,31(22):85.[doi:10.3969/j.issn.1006-1959.2018.01.030]
[3]庞 博,孙雪峰.小剂量不同浓度罗哌卡因在腰硬联合麻醉 前列腺电切术中的效果对比[J].医学信息,2018,31(09):112.[doi:10.3969/j.issn.1006-1959.2018.09.033]
　PANG Bo,SUN Xue-feng.Comparison of Effects of Low Dose Ropivacaine with Different Concentrations Combined Spinal-epidural Anesthesia during Prostatic Electrocision[J].Medical Information,2018,31(22):112.[doi:10.3969/j.issn.1006-1959.2018.09.033]
[4]刘卫东,王士雷.罗哌卡因复合羟考酮收肌管阻滞在膝关节镜手术ERAS中的应用[J].医学信息,2018,31(19):111.[doi:10.3969/j.issn.1006-1959.2018.19.033]
　LIU Wei-dong,WANG Shi-lei.Application of Ropivacaine Combined with Hydroxycodone Adductor Tube Block in ERAS of Knee Arthroscopy[J].Medical Information,2018,31(22):111.[doi:10.3969/j.issn.1006-1959.2018.19.033]
[5]姜 栋.罗哌卡因与布比卡因在腰麻-硬膜外联合阻滞应用的临床效果观察[J].医学信息,2019,32(01):151.[doi:10.3969/j.issn.1006-1959.2019.01.047]
　JIANG Dong.Clinical Observation of Ropivacaine and Bupivacaine in the Combined Use of Spinal Anesthesia and Epidural Block[J].Medical Information,2019,32(22):151.[doi:10.3969/j.issn.1006-1959.2019.01.047]
[6]尧友冬.不同剂量罗哌卡因腰硬联合麻醉在剖宫产中的应用效果及对产妇血流动力学的影响[J].医学信息,2022,35(17):132.[doi:10.3969/j.issn.1006-1959.2022.17.036]
　YAO You-dong.Effect on Different Doses of Ropivacaine with Combined Spinal and Epidural Anesthesia in Cesarean Section and its Influence on Maternal Hemodynamics[J].Medical Information,2022,35(22):132.[doi:10.3969/j.issn.1006-1959.2022.17.036]
[7]周 梅.右美托咪定静脉给药对罗哌卡因椎旁阻滞镇痛效果的影响[J].医学信息,2019,32(19):139.[doi:10.3969/j.issn.1006-1959.2019.19.045]
　ZHOU Mei.Effect of Intravenous Administration of Dexmedetomidine on Analgesic Effect of Ropivacaine Paraspinal Block[J].Medical Information,2019,32(22):139.[doi:10.3969/j.issn.1006-1959.2019.19.045]
[8]王海霞.腰麻联合硬膜外麻醉对剖宫产术麻醉效果的影响[J].医学信息,2019,32(20):100.[doi:10.3969/j.issn.1006-1959.2019.20.028]
　WANG Hai-xia.Effect of Spinal Anesthesia Combined with Epidural Anesthesia on the Anesthetic Effect of Cesarean Section[J].Medical Information,2019,32(22):100.[doi:10.3969/j.issn.1006-1959.2019.20.028]
[9]刘忠涛.罗哌卡因复合亚甲蓝椎旁阻滞对胸腔镜肺段切除术患者血流动力学及术后镇痛的影响[J].医学信息,2022,35(18):44.[doi:10.3969/j.issn.1006-1959.2022.18.010]
　LIU Zhong-tao.Effects of Ropivacaine Combined with Methylene Blue Paravertebral Block on Hemodynamics and Postoperative Analgesia in Patients Undergoing Thoracoscopic Segmentectomy[J].Medical Information,2022,35(22):44.[doi:10.3969/j.issn.1006-1959.2022.18.010]
[10]何华东.罗哌卡因复合瑞芬太尼腰麻-硬膜外麻醉在分娩镇痛中的价值[J].医学信息,2022,35(17):57.[doi:10.3969/j.issn.1006-1959.2022.17.013]
　HE Hua-dong.The Value of Ropivacaine with Remifentanil Combined Spinal-epidural Anesthesia in Labor Analgesia[J].Medical Information,2022,35(22):57.[doi:10.3969/j.issn.1006-1959.2022.17.013]

更新日期/Last Update: 1900-01-01