[1]夏姿询,李洪喜.不同剂量罗哌卡因腰-硬联合麻醉对剖腹产孕妇血流动力学及麻醉质量的影响[J].医学信息,2022,35(21):107-109.[doi:10.3969/j.issn.1006-1959.2022.21.026]
　XIA Zi-xun,LI Hong-xi.Effects of Different Doses of Ropivacaine in Combined Spinal-epidural Anesthesia on Hemodynamics and Anesthesia Quality of Cesarean Section Pregnant Women[J].Journal of Medical Information,2022,35(21):107-109.[doi:10.3969/j.issn.1006-1959.2022.21.026]
点击复制

不同剂量罗哌卡因腰-硬联合麻醉对剖腹产孕妇血流动力学及麻醉质量的影响()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年21期
页码:
107-109
栏目:
临床研究
出版日期:
2022-11-01

文章信息/Info

Title:
Effects of Different Doses of Ropivacaine in Combined Spinal-epidural Anesthesia on Hemodynamics and Anesthesia Quality of Cesarean Section Pregnant Women
文章编号:
1006-1959（2022）21-0107-03
作者:
夏姿询; 李洪喜
（1.佳木斯市中医医院麻醉科，黑龙江 佳木斯 154002；2.桦南县妇幼保健计划生育服务中心妇产科，黑龙江 桦南 154499）
Author(s):
XIA Zi-xun; LI Hong-xi
(1.Department of Anesthesiology,Jiamusi Hospital of Traditional Chinese Medicine,Jiamusi 154002,Heilongjiang,China;2.Department of Obstetrics and Gynecology,Huanan County Maternal and Child Health Family Planning Service Center,Huanan 154499,Heilongjiang,China)
关键词:
罗哌卡因; 腰-硬联合麻醉; 剖腹产; 血流动力学; 麻醉质量
Keywords:
Ropivacaine; Combined spinal-epidural anesthesia; Caesarean section; Hemodynamics; Quality of anesthesia
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2022.21.026
文献标志码:
A
摘要:
目的 研究不同剂量罗哌卡因腰-硬联合麻醉对剖腹产孕妇血流动力学及麻醉质量的影响。方法 选取2020年5月-2021年6月在我院行剖宫产的70例孕妇为研究对象，采用随机数字表法分为对照组和观察组，各35例。两组产妇均采用腰-硬联合麻醉，对照组用2 ml 0.75%的罗哌卡因，观察组用1 ml 0.75%的罗哌卡因，比较两组不同时间血流动力学指标、麻醉恢复指标、麻醉质量、新生儿1 min Apgar 评分及不良反应发生率。结果 麻醉15 min，两组心率（HR）、平均动脉压（MAP）、血氧饱和度（SpO2）比较，差异无统计学意义（P＞0.05）；分娩后、手术结束后观察组HR低于对照组，MAP、SpO2高于对照组（P＜0.05）；观察组麻醉消退时间、自主排尿时间短于对照组（P＜0.05）；观察组感觉阻滞、麻醉阻滞时间短于对照组（P＜0.05）；两组麻醉平面维持时间比较，差异无统计学意义（P＞0.05）；两组新生儿1 min Apgar评分比较，差异无统计学意义（P＞0.05）；观察组不良反应发生率为8.57%，低于对照组的20.00%（P＜0.05）。结论 小剂量罗哌卡因腰-硬联合麻醉对剖腹产孕妇血流动力学影响较小，麻醉起效快，麻醉恢复时间短，麻醉质量效果良好，且不良反应少，对新生儿Apgar评分无影响，具有相对更优的有效性和安全性。
Abstract:
Objective To study the effects of different doses of ropivacaine combined spinal-epidural anesthesia on hemodynamics and anesthesia quality in pregnant women undergoing caesarean section.Methods A total of 70 pregnant women who underwent cesarean section in our hospital from May 2020 to June 2021 were selected as the research objects. They were divided into control group and observation group by random number table method, with 35 cases in each group. Both groups were treated with combined spinal-epidural anesthesia. The control group was treated with 2 ml 0.75% ropivacaine, and the observation group was treated with 1 ml 0.75% ropivacaine. The hemodynamic indexes, anesthesia recovery indexes, anesthesia quality, neonatal 1 min Apgar score and incidence of adverse reactions were compared between the two groups.Results There was no significant difference in heart rate (HR), mean arterial pressure (MAP) and oxygen saturation (SpO2) between the two groups at 15 min after anesthesia (P>0.05). After delivery and at the end of operation, HR in the observation group was lower than that in the control group, and MAP and SpO2 were higher than those in the control group (P<0.05). The anesthesia regression time and spontaneous urination time in the observation group were shorter than those in the control group (P<0.05). The time of sensory block and anesthesia block in the observation group was shorter than that in the control group (P<0.05). There was no significant difference in the duration of anesthesia plane between the two groups (P>0.05). There was no significant difference in 1 min Apgar score between the two groups (P>0.05). The incidence of adverse reactions in the observation group was 8.57%, which was lower than 20.00% in the control group (P<0.05).Conclusion Low-dose ropivacaine combined spinal-epidural anesthesia has little effect on hemodynamics in pregnant women undergoing cesarean section. The onset of anesthesia is fast, the recovery time of anesthesia is short, the quality of anesthesia is good, and the adverse reactions are few. It has no effect on neonatal Apgar score, and has relatively better effectiveness and safety.

参考文献/References:

[1]罗瑞,高素琴,苏琳凯,等.小剂量罗哌卡因复合舒芬太尼行蛛网膜下腔麻醉用于剖宫产的麻醉效果观察[J].贵州医药,2020,44(7):1098-1099.[2]林雅丽,丁艺,覃淼,等.舒芬太尼联合罗哌卡因术后镇痛对剖宫产产妇泌乳素的临床效果观察[J].河北医学,2017,23(6):948-951.[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]赵晓楠,关雷,刘鹏飞,等.舒芬太尼复合罗哌卡因腹横筋膜阻滞用于腹腔镜胆囊切除术的镇痛效果[J].中国实验诊断学,2020,24(5):739-742.[5]郑丽花,杨淑芬,兰允平,等.舒芬太尼联合罗哌卡因用于瘢痕子宫与非瘢痕子宫剖宫产术后镇痛效果比较[J].浙江临床医学,2021,23(2):279-281.[6]陈斌.小剂量罗哌卡因复合舒芬太尼蛛网膜下腔麻醉在剖宫产术中的应用观察[J].现代诊断与治疗,2015,26(19):4393-4395.[7]龙家棋,何文明,邱文山,等.舒芬太尼复合不同剂量罗哌卡因对剖宫产产后镇痛的影响[J].白求恩医学杂志,2017,15(1):18-19.[8]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的麻醉效果[J].吉林医学,2016,37(3):634-636.[9]晏鑫.罗哌卡因与布比卡因 CSEA 对剖宫产孕妇血流动力学的影响[J].西南国防医药,2016,26(5):492-494[10]范育彩,孟凡民,杜献慧,等.不同剂量甲氧明预泵注对蛛网膜下腔阻滞麻醉下剖宫产产妇及新生儿的影响[J].中华实用诊断与治疗杂志,2016,30(4):409-411.[11]龚燕,瞿玉莲,朱敬畏.美托咪啶复合罗哌卡因对剖宫产孕妇血流动力学及麻醉质量的影响[J].中国计划生育学杂志,2017,25(3):184-186.[12]张茂鹏,刘伟,刘浩东.不同麻醉方式对妊娠合并重度肺动脉高压孕妇剖宫产术中血液动力学及术后结局的影响[J].中国实验诊断学,2016,20(9):1576-1579.[13]王涵,伍志超.术前辅助小剂量氯胺酮在全身麻醉剖宫产术对产妇和新生儿的影响[J].浙江临床医学,2016,18(10):1921-1923.[14]周玉琴,凤林.妊娠期糖尿病孕妇孕期体质量指数增长对母婴结局的影响分析[J].贵州医药,2018,42(6):709-711.[15]程英莉,吴建平,卢银军,等.罗哌卡因与布比卡因对剖宫产手术腰-硬联合麻醉患者血流动力学的影响[J].中国临床药理学杂志,2016,32(6):526-528.[16]祁晓燕,何全在.罗哌卡因腰-硬联合麻醉对剖腹产孕妇血流动力学及麻醉质量的影响[J].临床检验杂志(电子版),2017,6(2):239. [17]单家媛,姚建武,秦旭,等.罗哌卡因腰麻-硬膜外联合麻醉对剖宫产患者血清泌乳素水平的影响及其风险评估[J].现代生物医学进展,2017,17(4):717-719. [18]阎剑青.罗哌卡因与布比卡因在剖宫产手术腰-硬联合麻醉中的效果[J].中国药物与临床,2017,17(3):382-384. [19]林兴喆,陈启忠,李君.腰-硬联合分娩镇痛中辅助使用舒芬太尼的临床研究[J].中国妇幼保健,2016,31(14):2966-2968.[20]徐明坤,楚翠.小剂量盐酸罗哌卡因腰-硬联合麻醉对剖宫产孕妇血流动力学及麻醉质量的影响[J].河南外科学杂志,2017,23(1):57-58,59.

相似文献/References:

[1]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].Journal of Medical Information,2018,31(21):85.[doi:10.3969/j.issn.1006-1959.2018.01.030]
[2]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].Journal of Medical Information,2018,31(21):112.[doi:10.3969/j.issn.1006-1959.2018.09.033]
[3]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].Journal of Medical Information,2018,31(21):111.[doi:10.3969/j.issn.1006-1959.2018.19.033]
[4]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].Journal of Medical Information,2019,32(21):151.[doi:10.3969/j.issn.1006-1959.2019.01.047]
[5]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].Journal of Medical Information,2022,35(21):132.[doi:10.3969/j.issn.1006-1959.2022.17.036]
[6]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].Journal of Medical Information,2019,32(21):139.[doi:10.3969/j.issn.1006-1959.2019.19.045]
[7]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].Journal of Medical Information,2022,35(21):44.[doi:10.3969/j.issn.1006-1959.2022.18.010]
[8]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].Journal of Medical Information,2022,35(21):57.[doi:10.3969/j.issn.1006-1959.2022.17.013]
[9]贾先魁,宋建防,褚海辰,等.喷他佐辛复合罗哌卡因切口浸润麻醉在胸腔镜肺叶切除术中的应用[J].医学信息,2020,33(08):155.[doi:10.3969/j.issn.1006-1959.2020.08.051]
　JIA Xian-kui,SONG Jian-fang,CHU Hai-chen,et al.Application of Pentazocine Combined with Ropivacaine Incision Infiltration Anesthesia in Thoracoscopic Lobectomy[J].Journal of Medical Information,2020,33(21):155.[doi:10.3969/j.issn.1006-1959.2020.08.051]
[10]杨小强,丁 伟,张小亮,等.不同浓度罗哌卡因行胸椎旁神经阻滞麻醉对老年胸腔镜肺叶切除术患者围手术期镇痛的效果[J].医学信息,2021,34(24):131.[doi:10.3969/j.issn.1006-1959.2021.24.033]
　YANG Xiao-qiang,DING Wei,ZHANG Xiao-liang,et al.Perioperative Analgesic Effect of Different Concentrations of Ropivacaine for Thoracic Paravertebral Block Anesthesia in Elderly Patients Undergoing Thoracoscopic Lobectomy[J].Journal of Medical Information,2021,34(21):131.[doi:10.3969/j.issn.1006-1959.2021.24.033]

更新日期/Last Update: 1900-01-01