[1]杨晓旭.罗哌卡因联合舒芬太尼腰硬联合麻醉用于剖宫产手术的效果[J].医学信息,2021,34(11):164-166.[doi:10.3969/j.issn.1006-1959.2021.11.046]
　YANG Xiao-xu.Effect of Ropivacaine with Sufentanil Combined Spinal-epidural Anesthesia for Cesarean Section[J].Medical Information,2021,34(11):164-166.[doi:10.3969/j.issn.1006-1959.2021.11.046]
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罗哌卡因联合舒芬太尼腰硬联合麻醉用于剖宫产手术的效果()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年11期
页码:
164-166
栏目:
药物与临床
出版日期:
2021-06-01

文章信息/Info

Title:
Effect of Ropivacaine with Sufentanil Combined Spinal-epidural Anesthesia for Cesarean Section
文章编号:
1006-1959（2021）11-0164-03
作者:
杨晓旭
（天津市第二医院麻醉科，天津 300000）
Author(s):
YANG Xiao-xu
(Department of Anesthesiology,Tianjin Second Hospital,Tianjin 300000,China)
关键词:
罗哌卡因; 舒芬太尼; 剖宫产术; 腰硬联合麻醉
Keywords:
Ropivacaine; Sufentanil; Cesarean section; Combined spinal-epidural anesthesia
分类号:
R719.8
DOI:
10.3969/j.issn.1006-1959.2021.11.046
文献标志码:
A
摘要:
目的 观察罗哌卡因复合不同剂量的舒芬太尼腰硬联合麻醉用于剖宫产手术的效果。方法 选取2019年1月1日~11月1日天津市第二医院拟行择期剖宫产手术的产妇120例作为研究对象，按随机数字表法分成A组、B组和C组，每组40例。三组在手术前腰硬联合麻醉时均注入罗哌卡因与舒芬太尼混合液，注射速度分别为A组1 ml/10 s、B组1 ml/15 s、C组1 ml/20 s，测平面达到手术需要后，比较三组麻醉前（T0）、麻醉后1 min（T1）、5 min（T2）、15 min（T3）各时刻平均动脉压、心率，记录三组最高感觉阻滞平面例数、循环支持药物使用次数、恶心呕吐、需要硬膜外药物干预例数、新生儿Apgar评分。结果 A组麻醉后T1、T2、T3平均动脉压和心率低于T0时刻，且B组、C组，差异有统计学意义（P＜0.05）；而B组、C组各时刻平均动脉压和心率比较，差异无统计学意义（P＞0.05）。A组恶心呕吐次数、循环支持药物使用次数高于B组、C组，差异有统计学意义（P＜0.05）；B组需要硬膜外药物干预例数低于A组、C组，差异有统计学意义（P＜0.05）；而A组最高感觉阻滞平面例数比例高于B组、C组，差异有统计学意义（P＜0.05）。三组产妇新生儿出生后1、3、5 min时Apgar评分比较，差异无统计学意义（P＞0.05）。结论 罗哌卡因复合不同剂量的舒芬太尼腰硬联合麻醉用于剖宫产手术，蛛网膜下腔注药速度1 ml/15 s时能够更好满足手术需求，同时循环系统稳定，不良反应少，需要硬膜外额外给药干预的少，母婴更安全。
Abstract:
Objective To observe the effect of ropivacaine combined with different doses of sufentanil combined spinal-epidural anesthesia for cesarean section.Methods From January 1st to November 1st, 2019, 120 cases of parturients who planned to undergo elective cesarean section in Tianjin Second Hospital were selected as the research objects, and were divided into groups A, B and C according to the random number table method, each group 40 cases.The three groups were injected with a mixture of ropivacaine and sufentanil during combined spinal-epidural anesthesia before surgery.The injection speeds were 1 ml/10 s for group A, 1 ml/15 s for group B, and 1 ml/20 s for group C. After the measurement plane reached the operation requirement,compare the three groups of average arterial pressure and heart rate at each time before anesthesia (T0), 1 min (T1), 5 min (T2), and 15 min (T3) after anesthesia, and record the number of cases with the highest sensory block level, the number of times of circulatory support drugs used, and nausea and vomiting,the number of cases requiring epidural intervention, and the Apgar score of newborns.Results T1, T2, T3 mean arterial pressure and heart rate after anesthesia in group A were lower than T0,the difference between group B and group C was statistically significant (P<0.05);There was no statistically significant difference in the average arterial pressure and heart rate between group B and group C at each time (P>0.05).The number of nausea and vomiting and the use of circulatory support drugs in group A were higher than those in group B and C,the difference was statistically significant (P<0.05);The number of cases requiring epidural intervention in group B was lower than that in groups A and C,the difference was statistically significant (P<0.05);The highest sensory block level in group A was higher than that in group B and C,the difference was statistically significant (P<0.05).There was no statistically significant difference in Apgar scores at 1, 3, and 5 min after birth among the three groups of newborns (P>0.05).Conclusion Ropivacaine combined with different doses of sufentanil combined spinal-epidural anesthesia for cesarean section, the subarachnoid injection speed of 1 ml/15 s can better meet the needs of surgery.At the same time, the circulatory system is stable, the adverse reactions are few, and the extradural intervention is less, and the mother and baby are safer.

参考文献/References:

[1]Turner MJ,Reynolds CME,Léan E McMahon,et al.Caesarean section rates in women in the Republic of Ireland who chose to attend their obstetrician privately:a retrospective observational study[J].BMC Pregnancy and Childbirth,2020,20(1):548. [2]王珏,张益维,卢子会.灌注指数在预测剖宫产术蛛网膜下腔麻醉后仰卧位综合征的可行性研究[J].现代实用医学,2020,32(2):157-159. [3]夏劲,陈颖,吴耀华,等.罗哌卡因复合小剂量舒芬太尼腰硬联合麻醉用于剖宫产瘢痕部位妊娠患者剖宫产术的效果观察[J].中国医院用药评价与分析,2019,19(3):315-316. [4]Jakes AD,Bell A,Chiwera L,et al.Implementation of vaginal preparation prior to caesarean section[J].BMJ Open Quality,2020,9(3):976. [5]吕国栋,夏雨,齐超,等.罗哌卡因联合舒芬太尼腰硬联合麻醉在无痛分娩中临床应用价值研究[J].临床军医杂志,2019,47(9):119-120. [6]郑阳芝.罗哌卡因复合舒芬太尼用于剖宫产腰硬联合麻醉的临床效果分析[J].白求恩军医学院学报,2020,18(1):29-30. [7]陈文香.罗哌卡因复合舒芬太尼腰硬联合麻醉在剖宫产术中的应用效果观察[J].医学理论与实践,2018,31(9):1341-1342. [8]胡志强.罗哌卡因复合舒芬太尼腰硬联合麻醉在剖宫产术中的应用效果分析[J].河南外科学杂志,2018,24(3):62-63. [9]Sahoo H,Jeermison RK.Repeated Caesarean Section Delivery in India[J].Children and Youth Services Review,2020(116):105258. [10]周华民.舒芬太尼腰硬联合阻滞麻醉在剖腹产中的应用及对血液动力学、术后牵拉痛与寒战发生率的影响[J].罕少疾病杂志,2018,25(6):45-47. [11]张伟杰,邓慧俐,王丽萍,等.舒芬太尼复合罗哌卡因腰硬联合麻醉在无痛分娩中的麻醉效果分析[J].现代诊断与治疗,2020,31(4):38-39. [12]尹翔宇,黄凡,许紫舸.罗哌卡因复合舒芬太尼腰硬联合麻醉用于剖宫产术效果观察[J].临床合理用药杂志,2018,11(10):94-96. [13]夏勇.剖宫产麻醉应用罗哌卡因加舒芬太尼的效果[J].中国继续医学教育,2019,11(11):103-105. [14]徐砚华,张丽珺.小剂量舒芬太尼预防剖宫产术中寒战和牵拉疼痛的效果观察[J].安徽医药,2018,22(11):2237-2240. [15]邓红波,封享兰,张宗泽,等.舒芬太尼或羟考酮自控静脉镇痛联合腰方肌阻滞用于剖宫产术后镇痛的效果[J].临床麻醉学杂志,2020(2):124-127.

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更新日期/Last Update: 1900-01-01