[1]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):132-134.[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].Journal of Medical Information,2022,35(17):132-134.[doi:10.3969/j.issn.1006-1959.2022.17.036]
点击复制

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()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年17期
页码:
132-134
栏目:
药物与临床
出版日期:
2022-09-01

文章信息/Info

Title:
Effect on Different Doses of Ropivacaine with Combined Spinal and Epidural Anesthesia in Cesarean Section and its Influence on Maternal Hemodynamics
文章编号:
1006-1959(2022)17-0132-03
作者:
尧友冬
(金溪县人民医院麻醉科,江西 金溪 344800)
Author(s):
YAO You-dong
(Department of Anesthesiology,Jinxi County People’s Hospital,Jinxi 344800,Jiangxi,China)
关键词:
剖宫产腰硬联合麻醉罗哌卡因
Keywords:
Cesarean sectionCombined spinal and epidural anesthesiaRopivacaine
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2022.17.036
文献标志码:
A
摘要:
目的 探讨不同剂量罗哌卡因腰硬联合麻醉(CSEA)在剖宫产中的效果及对产妇血流动力学的影响。方法 选取2019年5月-2021年6月我院行剖宫产产妇78例,以随机数字表法将其分为CSEA 1组和CSEA 2组,每组39例。两组均行CSEA,CSEA 1组给予罗哌卡因2 ml,CSEA 2组给予罗哌卡因1 ml。比较两组麻醉前(T0)、麻醉后10 min(T1)、胎儿娩出后即刻(T2)、手术结束后即刻(T3)四个时间段中产妇心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)、麻醉起效时间、麻醉平面固定时间及镇痛效果。结果 CSEA 2组T1、T2、T3时段HR低于CSEA 1组,MAP、SpO2高于CSEA 1组(P<0.05);CSEA 2组麻醉起效时间长于CSEA 1组、麻醉平面固定时间短于CSEA 1组(P<0.05);CSEA 2组术后4、8、12 h VAS评分低于CSEA 1组(P<0.05)。结论 在剖宫产术中应用小剂量罗哌卡因CSEA不仅不影响麻醉效果及镇痛效果,还能够一定程度上减轻血流动力学的影响,具有临床应用价值。
Abstract:
Objective To investigate the effect on different doses of ropivacaine with combined spinal and epidural anesthesia (CSEA) in cesarean section and its influence on maternal hemodynamics.Methods A total of 78 parturients undergoing cesarean section in our hospital from May 2019 to June 2021 were selected and divided into CSEA 1 group and CSEA 2 group by random number table method, with 39 cases in each group. CSEA was performed in both groups. CSEA group 1 was given 2 ml ropivacaine, and CSEA group 2 was given 1 ml ropivacaine. Maternal heart rate (HR), mean arterial pressure (MAP), oxygen saturation (SpO2) before anesthesia (T0), 10 min after anesthesia (T1), immediately after fetal delivery (T2) and immediately after surgery (T3), onset time of anesthesia, anesthesia plane fixation time and analgesic effect were compared between the two groups.Results HR at T1, T2 and T3 in CSEA 2 group was lower than that in CSEA 1 group, MAP and SpO2 were higher than those in CSEA 1 group(P<0.05). The onset time of anesthesia in CSEA 2 group was longer than that in CSEA 1 group, and the anesthesia plane fixation time was shorter than that in CSEA 1 group(P<0.05). The VAS scores at 4,8 and 12 h after operation in CSEA 2 group were lower than those in CSEA 1 group(P<0.05).Conclusion The application of low-dose ropivacaine CSEA in cesarean section not only does not affect the anesthetic effect and analgesic effect, but also can reduce the hemodynamic effect to a certain extent, which has clinical application value.

参考文献/References:

[1]陈萍,陈奎,何常佑,等.不同麻醉方式对剖腹产孕妇的麻醉效果和血流动力学影响分析[J].西南国防医药,2020,30(7):658-661. [2]李欣,王瑞,谯瞧,等.腰硬联合麻醉在妊娠高血压综合征剖宫产术应用及对血流动力学和血液流变学影响[J].中国计划生育学杂志,2019,27(11):1460-1463.[3]邓国魁,李云现,谢红,等.罗哌卡因复合舒芬太尼腰硬联合麻醉用于剖宫产术对血流动力学及肌肉松弛程度的影响[J].河北医学,2021,27(6):1049-1053. [4]杨进斌,吴奕涵.剖宫产术腰-硬联合麻醉中头部抬高可提供稳定的血流动力学以及更适宜的阻滞平面[J].中国实验诊断学,2019,23(11):1946-1948. [5]刘超,陶中龙.小剂量盐酸罗哌卡因联合舒芬太尼用于剖宫产手术的临床研究[J].中国临床药理学杂志,2021,37(2):111-114. [6]赵嫣红,徐韬,郑静,等.静脉推注去氧肾上腺素预防剖宫产腰硬联合麻醉后低血压90%有效剂量及其对母婴影响[J].国际麻醉学与复苏杂志,2021,42(6):599-604. [7]张亚军,侯宪佳,丁浩,等.腰硬联合阻滞麻醉与全麻对重度子痫前期剖宫产产妇血流动力学和新生儿的影响[J].广东医学,2018,39(9):1307-1310.[8]吴永华,陈学强,黄春贵,等.低剂量等比重罗哌卡因腰硬联合麻醉在高原剖宫产中的应用[J].中国新药与临床杂志,2020,39(4):217-220. [9]张毅,李任国,冯彦红,等.罗哌卡因和舒芬太尼腰-硬联合 对于分娩镇痛在潜伏期与活跃期效果的比较[J].基础医学与临床,2020,40(5):692-695. [10]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,2020,36(2):124-127. [11]潘梦婷,黄兴龙.腰硬联合麻醉与连续硬膜外麻醉对剖宫产产妇血流动力学及麻醉质量的影响[J].中国妇幼保健,2020,35(13):2529-2532. [12]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):315-316,319. [13]熊中华,李代辉.不同剂量罗哌卡因等比重腰麻-硬膜外联合阻滞对母婴肾素活性、血管紧张素Ⅱ及醛固酮系统的影响[J].中国基层医药,2019,26(11):1364-1367. [14]牛富国,李衔强,张彦匣,等.氢吗啡酮复合罗哌卡因用于剖宫产术后硬膜外自控镇痛效果及对血流动力学、氧化应激、内质网应激的影响[J].河北医药,2019,41(11):1623-1626,1631. [15]陈军,朱邵军,张瑞东.腰椎-硬膜外联合麻醉在剖宫产手术中的疗效研究[J].重庆医学,2019,48(24):4173-4175. [16]岳婷,任静,刘淑香.高龄产妇与适龄产妇在相同浓度罗哌卡因麻醉下的麻醉效果及术中血流动力学稳定度的比较研究[J].中国妇幼保健,2019,34(7):1666-1669. [17]蔡孟杰,庹鹏,詹鸿,等.不同浓度及容量罗哌卡因对剖宫产术后疼痛及快速康复的影响[J].中华生物医学工程杂志,2019,25(1):100-104.

相似文献/References:

[1]刘汉芬.剖宫产术后护理干预对产妇康复效果的影响分析[J].医学信息,2018,31(01):169.[doi:10.3969/j.issn.1006-1959.2018.01.067]
 LIU Han-fen.Effect of Nursing Intervention on Maternal Rehabilitation after Cesarean Section[J].Journal of Medical Information,2018,31(17):169.[doi:10.3969/j.issn.1006-1959.2018.01.067]
[2]刘 礼.影响剖宫产术后瘢痕子宫足月分娩结局的相关因素分析[J].医学信息,2018,31(02):109.[doi:10.3969/j.issn.1006-1959.2018.02.039]
 LIU Li.Analysis of Related Factors Influencing the Outcome of Full Term Delivery of Scar Uterus after Cesarean Section[J].Journal of Medical Information,2018,31(17):109.[doi:10.3969/j.issn.1006-1959.2018.02.039]
[3]李 欢,刘 俊,夏军辉.妊娠期高血压疾病患者血浆Pro BNP水平及其临床意义[J].医学信息,2018,31(04):158.[doi:10.3969/j.issn.1006-1959.2018.04.059]
 LI Huan,LIU Jun,XIA Jun-hui.Plasma Pro BNP Levels in Patients with Hypertensive Disorder Complicating Pregnancy and their Clinical Significance[J].Journal of Medical Information,2018,31(17):158.[doi:10.3969/j.issn.1006-1959.2018.04.059]
[4]鲁秋彤.经阴道彩色多普勒超声在诊断剖宫产子宫疤痕妊娠中的 价值研究[J].医学信息,2018,31(05):160.[doi:10.3969/j.issn.1006-1959.2018.05.058]
 LU Qiu-tong.The Value of Transvaginal Color Doppler Ultrasound in the Diagnosis of Cesarean Scar Pregnancy[J].Journal of Medical Information,2018,31(17):160.[doi:10.3969/j.issn.1006-1959.2018.05.058]
[5]蒋红梅.子宫下段横形环状压迫缝合术治疗前置胎盘剖宫产术中 胎盘剥离面出血的临床研究[J].医学信息,2018,31(07):120.[doi:10.3969/j.issn.1006-1959.2018.07.040]
 JIANG Hong-mei.Clinical Study on the Treatment of Placental Exfoliation Bleeding in Caesarean Section of Placenta Previa by Transverse Annular Compression Suture of Lower Uterine Segment[J].Journal of Medical Information,2018,31(17):120.[doi:10.3969/j.issn.1006-1959.2018.07.040]
[6]冉会仁.小剂量舒芬太尼在剖宫产术麻醉中预防寒战及 牵拉痛的疗效评价[J].医学信息,2018,31(08):101.[doi:10.3969/j.issn.1006-1959.2018.08.032]
 RAN Hui-ren.Evaluation of the Efficacy of Low-dose Sufentanil in Preventing Chills and Pulling Pain during Cesarean Section Anesthesia[J].Journal of Medical Information,2018,31(17):101.[doi:10.3969/j.issn.1006-1959.2018.08.032]
[7]迟福涛.腰硬联合麻醉在无痛分娩中的效果分析[J].医学信息,2018,31(08):105.[doi:10.3969/j.issn.1006-1959.2018.08.034]
 CHI Fu-tao.Analysis of the Effect of Combined Spinal Epidural Anesthesia in Painless Delivery[J].Journal of Medical Information,2018,31(17):105.[doi:10.3969/j.issn.1006-1959.2018.08.034]
[8]王玉霞.剖宫产术后子宫疤痕妊娠的临床诊治[J].医学信息,2018,31(10):48.[doi:10.3969/j.issn.1006-1959.2018.10.015]
 WANG Yu-xia.Clinical Diagnosis and Treatment of Uterine Scar Pregnancy after Cesarean Section[J].Journal of Medical Information,2018,31(17):48.[doi:10.3969/j.issn.1006-1959.2018.10.015]
[9]熊 丽,蒋明珉,何娅娟.以护士为主导的疼痛管理模式在剖宫产围手术期的应用研究[J].医学信息,2019,32(01):179.[doi:10.3969/j.issn.1006-1959.2019.01.058]
 XIONG Li,JIANG Ming-min,HE Ya-juan.Application Study of Nurse-led Pain Management Model in Perioperative Period of Cesarean Section[J].Journal of Medical Information,2019,32(17):179.[doi:10.3969/j.issn.1006-1959.2019.01.058]
[10]龙俊青.臀位外倒转术的应用研究[J].医学信息,2019,32(12):61.[doi:10.3969/j.issn.1006-1959.2019.12.019]
 LONG Jun-qing.Application Study of Breech Presentation[J].Journal of Medical Information,2019,32(17):61.[doi:10.3969/j.issn.1006-1959.2019.12.019]
[11]王 颖,石显江,陈斯乔,等.多巴胺预注射在剖宫产腰硬联合麻醉的临床应用[J].医学信息,2019,32(11):150.[doi:10.3969/j.issn.1006-1959.2019.11.044]
 WANG Ying,SHI Xian-jiang,CHEN Si-qiao,et al.Clinical Application of Dopamine Pre-injection in Cesarean Section Combined with Spinal Anesthesia[J].Journal of Medical Information,2019,32(17):150.[doi:10.3969/j.issn.1006-1959.2019.11.044]
[12]叶 芸.不同剂量布比卡因腰硬联合麻醉对剖宫产产妇血液流变学的影响[J].医学信息,2023,36(22):120.[doi:10.3969/j.issn.1006-1959.2023.22.027]
 YE Yun.Effects of Different Doses of Bupivacaine Combined Spinal-epidural Anesthesia on Hemorheology in Parturients Undergoing Cesarean Section[J].Journal of Medical Information,2023,36(17):120.[doi:10.3969/j.issn.1006-1959.2023.22.027]

更新日期/Last Update: 1900-01-01