小剂量罗哌卡因腰-硬联合麻醉对剖宫产孕妇血流动力学及麻醉质量的影响

摘要

Objective To study the impact of small dose ropivacaine combined spinal epidural anesthesia on hemodynamics and anesthetic quality in pregnant women with cesarean section .Methods 120 pregnant women vol‐untarily undergoing caesarean section in our hospital were selected the research subjects and randomly divided into the observation group and the control group according to the random number table ,62 cases in each group .The two groups adopted the combined spinal epidural anesthesia .The observation group adopted 1% ropivacaine 1 .0 mL and fentanyl 10 μg for conducting combined spinal epidural anesthesia ,while the control group was given 1% ropivacaine 1 .5 mL .The hemodynamic indexes and anesthetic quality were compared between the two groups .Results The de‐scent range of SBP ,DBP at 5 ,10 min after anesthesia in the observation group were significantly lower than those in the control group ,HR ascent range was significantly lower than that in the control group ;the motor block onset time ,sensory block onset time and maximum sensory block plane were significantly lower than those in the control group ;there were no statistically significant difference in maximum motor block level between the two groups .Con‐clusion small dose ropivacaine combined spinal epidural anesthesia conduces to stabilize the intraoperative hemody‐namic indexes and improves the anesthetic quality .%目的：探讨小剂量罗哌卡因腰‐硬联合麻醉对剖宫产孕妇血流动力学及麻醉质量的影响。方法选取来该院自愿行剖宫产手术的124例孕妇为研究对象，采用随机数字表法分为观察组和对照组各62例，两组产妇均采用腰‐硬联合麻醉，观察组采用1．0 mL 1％罗哌卡因联合10μg 芬太尼进行麻醉，对照组采用1．5 mL 1％罗哌卡因进行麻醉，比较血流动力学指标及麻醉质量。结果麻醉后5、10 min ，观察组收缩压、舒张压下降幅度明显低于对照组，心率上升幅度明显低于对照组；运动阻滞起效时间、感觉阻滞起效时间、最大感觉阻滞平面均明显低于对照组；两组最大运动阻滞程度比较差异无统计学意义（P＞0．05）。结论小剂量罗哌卡因腰‐硬联合有利于稳定术中血流动力学指标，提高麻醉质量。