[1]杨 蕾,巩晓洁.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].医学信息,2024,37(13):98-101.[doi:10.3969/j.issn.1006-1959.2024.13.019]
　Effects of Low-dose Ropivacaine Hydrochloride Combined Spinal-epidural Anesthesia on Hemodynamics and Anesthesia Quality in Pregnant Women Undergoing Cesarean Section.Effects of Low-dose Ropivacaine Hydrochloride Combined Spinal-epidural Anesthesia on Hemodynamics and Anesthesia Quality in Pregnant Women Undergoing Cesarean Section[J].Journal of Medical Information,2024,37(13):98-101.[doi:10.3969/j.issn.1006-1959.2024.13.019]
点击复制

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()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年13期
页码:
98-101
栏目:
论著
出版日期:
2024-07-01

文章信息/Info

Title:
Effects of Low-dose Ropivacaine Hydrochloride Combined Spinal-epidural Anesthesia on Hemodynamics and Anesthesia Quality in Pregnant Women Undergoing Cesarean Section
文章编号:
1006-1959（2024）13-0098-04
作者:
杨 蕾; 巩晓洁
（天津市第二医院麻醉科，天津 300000）
Author(s):
Effects of Low-dose Ropivacaine Hydrochloride Combined Spinal-epidural Anesthesia on Hemodynamics and Anesthesia Quality in Pregnant Women Undergoing Cesarean Section
(Department of Anesthesia,Tianjin Second Hospital,Tianjin 300000,China)
关键词:
盐酸罗哌卡因; 腰-硬联合麻醉; 剖宫产; 血流动力学; 麻醉质量
Keywords:
Ropivacaine hydrochloride; Combined spinal-epidural anesthesia; Cesarean section; Hemodynamics; Anesthesia quality
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2024.13.019
文献标志码:
A
摘要:
目的 分析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。方法 选取2022年1月-2023年1月在我院进行剖宫产分娩的68例产妇为研究对象，采用随机数字表法分为对照组和观察组，各34例。对照组采用正常剂量盐酸罗哌卡因行腰-硬联合麻醉，观察组采用小剂量盐酸罗哌卡因行腰-硬联合麻醉，比较两组麻醉质量（麻醉阻滞评分、感觉阻滞起效时间、运动阻滞起效时间、麻醉平面固定时间）、不同时间点（麻醉前、麻醉后10 min、手术结束后）血流动力学指标[血氧饱和度（SpO2）、平均动脉压（MAP）、心率（HR）]、不同时间点（术后2、6、24 h）疼痛（VAS）评分及不良反应发生率。结果 观察组麻醉阻滞评分、感觉阻滞起效时间、运动阻滞起效时间与对照组比较，差异无统计学意义（P＞0.05），观察组麻醉平面固定时间长于对照组（P＜0.05）；两组麻醉后10 min SpO2均低于麻醉前，MAP、HR均高于麻醉前，且观察组SpO2高于对照组，MAP、HR低于对照组（P＜0.05）；手术结束后，两组SpO2均升高，MAP、HR均降低，但观察组SpO2高于对照组，MAP、HR低于对照组（P＜0.05）；术后2 h，观察组VAS评分与对照组比较，差异无统计学意义（P＞0.05），术后6、24 h，观察组VAS评分低于对照组（P＜0.05）；观察组不良反应发生率低于对照组（P＜0.05）。结论 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均具有积极的影响，能减小血流动力学波动，减轻产妇术后疼痛，降低不良反应发生率，且可实现基本一致的麻醉质量，具有更显著的临床应用优势。
Abstract:
Objective To investigate the effect of low-dose ropivacaine hydrochloride combined spinal-epidural anesthesia on hemodynamics and anesthesia quality in pregnant women undergoing cesarean section.Methods A total of 68 parturients who underwent cesarean section in our hospital from January 2022 to January 2023 were selected as the research objects. They were divided into control group and observation group by random number table method, with 34 parturients in each group. The control group was treated with normal dose of ropivacaine hydrochloride for combined spinal-epidural anesthesia, and the observation group was treated with low dose of ropivacaine hydrochloride for combined spinal-epidural anesthesia. The anesthesia quality (anesthesia block score, sensory block onset time, motor block onset time, anesthesia plane fixation time), hemodynamic indexes [oxygen saturation (SpO2), mean arterial pressure (MAP), heart rate (HR)] at different time points (before anesthesia, 10 min after anesthesia, after operation), pain (VAS) score at different time points (2, 6, 24 h after operation) and incidence of adverse reactions were compared between the two groups.Results There were no significant difference in anesthesia block score, sensory block onset time and motor block onset time between the observation group and the control group (P>0.05). The fixed time of anesthesia plane in the observation group was longer than that in the control group (P<0.05). At 10 min after anesthesia, SpO2 in the two groups was lower than that before anesthesia, MAP and HR were higher than those before anesthesia, and SpO2 in the observation group was higher than that in the control group, MAP and HR were lower than those in the control group (P<0.05). After the operation, SpO2 increased, MAP and HR decreased in both groups, but SpO2 in the observation group was higher than that in the control group, and MAP and HR were lower than those in the control group (P<0.05). At 2 h after operation, there was no significant difference in VAS score between the observation group and the control group (P>0.05). At 6 and 24 h after operation, the VAS score of the observation group was lower than that of the control group (P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group (P<0.05).Conclusion Low-dose ropivacaine hydrochloride combined spinal-epidural anesthesia has a positive effect on hemodynamics and anesthesia quality of pregnant women undergoing cesarean section, which can reduce hemodynamic fluctuations, reduce postoperative pain and reduce the incidence of adverse reactions. Meanwhile, it can achieve basically the same anesthesia quality and has more significant clinical application advantages.

参考文献/References:

[1]杨远平.小剂量盐酸罗哌卡因腰－硬联合麻醉对剖腹产产妇麻醉效果及血流动力学的影响[J].辽宁医学杂志,2018,30(6):56-58.[2]王延飞.罗哌卡因腰-硬联合麻醉质量及对剖腹产孕妇血流动力学的影响[J].内蒙古医学杂志,2017,49(10):1219-1220.[3]苏盛剑.小剂量盐酸罗哌卡因腰硬联合麻醉对剖宫产产妇血流动力学及麻醉质量的影响分析[J].基层医学论坛,2017,21(2):165-166. [4]黄翠英,黎桂萍,梁嘉文.小剂量盐酸罗哌卡因腰硬联合麻醉对剖宫产产妇的麻醉效果及血流动力学的影响[J].包头医学院学报,2018,34(9):63-64.[5]黄伟伟,张加强,刘莉影,等.不同剂量罗哌卡因腰-硬联合麻醉对剖宫产产妇术后VAS评分和血流动力学水平的影响[J].中国妇幼保健,2022,37(17):3279-3282.[6]袁美玲.小剂量盐酸罗哌卡因腰-硬联合麻醉对剖宫产产妇麻醉效果及血流动力学的影响[J].吉林医学,2020,41(7):1630-1631.[7]郑斌.小剂量盐酸罗哌卡因腰硬联合麻醉应用于剖宫产产妇的效果及对血流动力学的影响[J].临床医学,2018,38(3):60-62.[8]肖木芬.小剂量盐酸罗哌卡因腰-硬联合麻醉对剖宫产产妇血流动力学及麻醉质量的影响[J].河南外科学杂志,2018,24(1):144-145.[9]孟婧雅.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].中国药物评价,2017,34(6):436-438.[10]刘飞.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].基层医学论坛,2017,21(28):3839-3840.[11]刘文奎．剖宫产术中舒芬太尼联合小剂量罗哌卡因蛛网膜下腔麻醉的麻醉效果及安全性分析[J].中国妇幼保健,2018,33(17):3899-3901．[12]李兆阳.小剂量罗哌卡因腰-硬联合麻醉在剖宫产术中的应用[J].河南医学研究,2018,27(7):1307-1308．[13]程明锋.罗哌卡因复合舒芬太尼腰-硬联合麻醉用于剖宫产术的效果分析[J].吉林医学,2018,39(4):708-709.[14]袁美玲.小剂量盐酸罗哌卡因腰-硬联合麻醉对剖宫产产妇麻醉效果及血流动力学的影响[J].吉林医学,2020,41(7):1630-1631.[15]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):58-59.[16]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.[17]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.[18]Sun H,Yang L,Wu L,et al.The effect of ropivacaine and bupiva caine on hemodynamic in patients undergoing cesarean section with combined spinal－epidural anesthesia[J].Beijing Med J,2019,40(26):556-559.[19]徐军,方建塔.不同浓度罗哌卡因对剖宫产术后镇痛效应及安全性研究[J].中国临床药理学杂志,2019,35(22):2830-2832.[20]朱爱兵,沈明坤,姚飞,等.罗哌卡因切口浸润联合羟考酮静脉输注对剖宫产术后宫缩痛和早期恢复的影响[J].临床麻醉学杂志,2019,35(11):1084-1088.

相似文献/References:

[1]王振山,李艳丽,李晓娟,等.不同浓度罗哌卡因应用于分娩镇痛的临床观察[J].医学信息,2019,32(02):154.[doi:10.3969/j.issn.1006-1959.2019.02.046]
　WANG Zhen-shan,LI Yan-li,LI Xiao-juan,et al.Clinical Observation of Different Concentrations of Ropivacaine for Labor Analgesia[J].Journal of Medical Information,2019,32(13):154.[doi:10.3969/j.issn.1006-1959.2019.02.046]
[2]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.[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(13):107.[doi:10.3969/j.issn.1006-1959.2022.21.026]
[3]郑丽娟,王清平.盐酸罗哌卡因联合舒芬太尼对剖宫产患者术后镇痛效果及血流动力学的影响[J].医学信息,2024,37(13):102.[doi:10.3969/j.issn.1006-1959.2024.13.020]
　Effect of Ropivacaine Hydrochloride Combined with Sufentanil on Postoperative Analgesia and Hemodynamics in Patients Undergoing Cesarean Section.Effect of Ropivacaine Hydrochloride Combined with Sufentanil on Postoperative Analgesia and Hemodynamics in Patients Undergoing Cesarean Section[J].Journal of Medical Information,2024,37(13):102.[doi:10.3969/j.issn.1006-1959.2024.13.020]
[4]周 琳.盐酸罗哌卡因联合舒芬太尼硬膜外麻醉在足月妊娠产妇无痛分娩中的临床应用效果[J].医学信息,2024,37(16):104.[doi:10.3969/j.issn.1006-1959.2024.16.023]
　ZHOU Lin.Clinical Application Effect of Ropivacaine Hydrochloride Combined with Sufentanil Epidural Anesthesia in Painless Labor of Full-term Pregnant Women[J].Journal of Medical Information,2024,37(13):104.[doi:10.3969/j.issn.1006-1959.2024.16.023]

更新日期/Last Update: 1900-01-01