罗哌卡因与可乐定复合罗哌卡因硬膜外麻醉应用于剖宫产的效果评价

摘要

目的 比较罗哌卡因与罗哌卡因+可乐定硬膜外麻醉应用于剖宫产手术的麻醉效果.方法 选择102位在硬膜外麻醉下行剖宫产手术的足月单胎初产妇,随机、双盲分成两组:罗哌卡因组(R组)用药为0.75％罗哌卡因12ml,罗哌卡因+可乐定组(RC组)用药为0.75％罗哌卡因12 ml+可乐定75 μg,麻醉平面最高达到T6～T7,术中观察记录两组产妇的麻醉效果、心率、血压及新生儿Apgar评分及围术期不良反应.结果 两组产妇的人口学特征、新生儿Apgar评分及不良反应差异无显著性.RC组的镇痛起效时间为8.64 min,完全起效时间为12.26 min,运动阻滞时间为17.34 min,均短于R组的11.36 min、15.12 min、21.70 min,差异有显著性(P＜0.05).RC组牵拉痛率为20.4％、寒战发生率为7.4％,均低于R组的66.7％、33.3％,差异有显著性(P＜0.05).结论 可乐定+罗哌卡因合用于硬膜外麻醉下剖宫产,可缩短罗哌卡因的麻醉起效时间、减小寒战等副作用.%Objectve To evaluate the effects of clonidine added to ropivacaine for epidural anesthesia of cesarean section.Methods 102 pregnant women for elective cesarean sectidon under epidural anesthesia were selected and randomly divided into two groups:(R group) received 0.75％ ropivacaine 12 ml,(RC group)received 0.75％ ropivacaine 12 ml added clonidine 75 μ g,two groups of epidural anesthesia were performed at T6-T7.The effects of anesthesia,the maternal heart rate and blood pressure,the neonatal Apgar score and perioperative adverse reactions were recorded.Results Two groups of demographic characteristics,neonatal Apgar score and adverse reaction had no significant difference,the analgesic effect to time,fully work time and the onset time of motor block were significantly shorter than those in group RC as compared with group R(P＜ 0.05).Conclusion The addition of clonidine to ropivacaine under epidural anesthesia for cesarean section can shorter the effect time of anesthesia and reduced the shivering side effect.