[目的]观察小剂量芬太尼复合罗哌卡因腰麻-硬膜外麻醉用于剖宫产术的临床效果、安全性和不良反应.[方法]100例产科病人随机分为A、B两组,每组50例,均行腰麻-硬膜外麻醉.A组给予罗哌卡因7.5 mg(1 mL)+芬太尼20 μg(1 mL)+10%葡萄糖0.5 mL;B组给予罗哌卡因15 mg(2 mL)+10%葡萄糖0.5 mL,以0.1 mL/s的速度向骶尾方向推注.观察术中胎儿娩出后Apgar评分、起效时间、下肢运动神经阻滞程度、病人自感下肢麻醉消失时间、改良Bromage评分、视觉模拟评分(VAS)和不良反应.[结果]两组病人的年龄、体重、身高、手术时间和新生儿出生1 min、5 min的Apgar评分、两组切皮时的VAS评分差异无显著性(P>0.05).A组与B组相比,在下肢运动神经阻滞程度、下肢麻醉消失时间、腰麻后病人自感下肢深阻滞不适例数和不良反应中的低血压、心动过缓、寒战、恶心呕吐、麻醉平面超过胸2的发生率相比差异有显著性(P<0.05);[结论]小剂量芬太尼20 μg复合罗哌卡因可安全有效的用于剖宫产蛛网膜下腔阻滞.%[Objective]To observe the clinical efficacy, safety and side reactions of low dosage of fentanil plus ropivacaine spinal-epidural anesthesia for elective caesarean operation. [Methods] A total of 100 parturients with spinal epidural anesthesia were randomly divided into group A and group B with 50 in each. Group A was given Ropivacaine 7.5 mg(1mL), fentanil 20 μg(1 mL) and 10％ glucose 0.5 mL. Group B was given ropivacaine 15mg (2mL) and 10％ glucose 0.5mL. The speed of infusion was 0.1 mL/min. The Apgar score, duration of action,the degree of lower limb motor block, the disappear time of lower limb anesthesia felt by patients, modified Bro mage score, visual analogue scale(VAS) and adverse reactions were observed. [Results]There was no significant difference in age, weight, height, operation time, neonatal Apgar score at 1min and 5min and VAS score while skin incision between two groups( P ＞0.05). But there was significant difference in the degree of the lower limb motor block, the disappear time of lower limb anesthesia felt by patients, the number of patients who felt unwell deep blockage of lower limbs and the incidence of side reactions such as low blood pressure, bradycardia, cold shiv er, nausea and vomiting and the anesthesia height above the second thoracic vertebra between two groups( P ＜0.05). [Conclusion]Low dosage of fentanil 20μg plus ropivacaine is safe and effective for subarachnoid block dur lng caesarean operation.
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