不同浓度的罗哌卡因经蛛网膜下腔阻滞应用于剖宫产手术的临床麻醉效果分析

摘要

目的 采用经蛛网膜下腔阻滞法,比较不同浓度的罗哌卡因用于剖宫产手术的临床麻醉效果.方法 将我院2012年1月至2015年4月200例经蛛网膜下腔阻滞法麻醉进行剖宫产手术的孕妇分成高剂量组(60例,0.75%罗哌卡因,2mL)、中剂量组(70例,0.5%罗哌卡因,2mL)、低剂量组(70例,0.5%罗哌卡因,1.5mL).比较各组的蛛网膜下腔阻滞效应及相关不良反应.结果 三组患者的运动阻滞起效时间、感觉阻滞起效时间之间差异无统计学意义(P>0.05),低剂量组运动阻滞持续时间、感觉阻滞持续时间较高剂量组短,差异有统计学意义(P<0.05);低剂量组与中剂量组麻醉前后动脉压的降低幅度显著低于高剂量组,差异有统计学意义(P<0.05),腹肌松弛程度三组间差异无统计学意义(P>0.05);高剂量组患者心动过缓、呼吸困难发生率显著高于低剂量组及中剂量组,差异有统计学意义(P<0.05).结论 高剂量组虽然疗效优于低剂量组,但不良反应发生率显著提高,且低剂量组的麻醉效果已经能达到手术的要求,罗哌卡因应用于剖宫产手术推荐低剂量.%Objective To compare clinical anesthetic effect of different concentrations of Ropivacaine for subarachnoid block in cesarean section.Methods 200 cases of gravidas receiving cesarean section by subarachnoid anesthesia during the period from January 2012 to April 2015 in our hospital were divided into 3 groups-60 cases for high dosage group with 2mL 0.75% Ropivacaine,70 cases for medium dosage group with 2mL 0.5% Ropivacaine and 70 cases for low dosage group with 1.5mL 0.5% Ropivacaine.The blocking effects and related adverse reactions of each group were compared.Results Comparing the onset time of motor and sensory block of the three group,there being no statistically significant difference(P>0.05).Maintaining time of motor and sensory block of low dosage group was shorter than high dosage group,the difference being statistically significant(P<0.05).The reduce extent of arterial pressure after anesthesia in low dosage group and medium dosage group was significantly lower than high dosage group,the difference being statistically significant(P<0.05).There was no statistically significant difference of abdominal muscle relaxation degree among the three groups (P>0.05).Incidence of bradycardia and dyspnea in high dosage group was significantly higher than those in low dosage group and medium dosage group,the difference being statistically significant(P<0.05).Conclusion As for high dosage group,although its effect is better than low dosage group,its adverse reaction incidence significantly increase.Meanwhile,the anesthetic effect of low dosage group is able to reach the operation requirements,so low dosage of Ropivacaine is recommended in caesarean section.