Objective To investigate the effect of low-dose ropivacaine combined with spinal anesthesia on RAAS system and complications of cesarean section. Methods From September 2015 to June 2017,408 cases gravity of combined spinal-epidural anesthesia on cesarean section were retrospectively analyzed in our hospital. According to preoperative anesthesia,different doses of ropivacaine were divided into two groups:routine group (n=204) and low dose group(n=204). The effects of anesthesia were compared,and the serum renin activity,angiotensin II and aldosterone concentrations in maternal and fetal serum were measured. Results There were no anesthesia failure cases in two groups. 6 cases of weight low dose group and 4 cases of routine group had pain at the upper end of the incision,all of which received epidural administration of 2 % lidocaine 4ml. The others patients had good block effect and no obvious discomfort during operation. Compared with T0,the levels of PRA,AT-II and ACD in both groups decreased significantly at T1,T2,T3. The level of PRA in low dose group was significantly lower than that of routine group(P0.05). At the same time,there were no significant difference between the two groups in the levels of PRA,AT-IIand ACD in fetal umbilical vein blood and umbilical artery blood(P>0.05). Complications such as hypotension,malignant vomiting and abnormal heart rate occurred in both groups after operation,but the incidence of complication in routine group was significantly higher than that of low dose group(P0.05),同时两组胎儿脐静脉血和脐动脉血PRA、AT-II、ACD水平比较,差异无统计学意义(P>0.05).两组产妇术后均出现低血压、恶心呕吐、心率异常等并发症,但常规组并发症发生率明显高于小剂量组(P<0.05).结论 小剂量等比重罗哌卡因蛛网膜下腔-硬脊膜外麻醉效果与常规组相当,但小剂量等比重罗哌卡因麻醉更有利于母婴RAAS系统的稳定,减少产妇术后并发症的发生.
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