摘要
目的观察罗哌卡因复合曲马多蛛网膜下隙阻滞用于剖宫产术的麻醉效能。方法90例美国麻醉医师协会(ASA)分级Ⅰ～Ⅱ级、择期行剖官产术的产妇。随机均分为3组。采用蛛网膜下隙阻滞联合硬膜外阻滞,R组蛛网膜下隙给予罗哌卡在10mg,RF组予罗哌卡因10 mg+芬太尼20μg,RT组予罗哌卡因10 mg+曲马多20 mg。观察起效时间、感觉阻滞及运动阻滞情况。术后随访完全镇痛时间、有效镇痛时间、术后产妇感觉晟疼痛时的视觉模拟(VAS)评分以及头痛、恶心等并发症。结果3组产妇的感觉阻滞起效时间、最大阻滞平面、达最大阻滞平面时间以及达布(Bromage)Ⅲ级的例数和时间的差异均无显著性(P值均＞0．05)。RF组和RT组完全镇痛时间、有效镇痛时间、术后产妇感觉最疼痛时的VAS评分、术后镇痛药使用比例与R组比较差异均有显著性(P值均＜0．05),而RF组与RT组间的差异无显著性(P值均＞0．05)。结论与复合芬太尼一样,罗哌卡因复合曲马多蛛网膜下隙阻滞用于剖宫产术能达到良好的麻醉效果,延长术后镇痛的时间。
Objective To investigate the efficacy and safety of ropivacaine combined with tramdol for spinal anesthesia in parturients undergoing cesarean section. Methods Ninety parturients （ASA Ⅰ - Ⅱ ） scheduled for cesarean section were randomized into three groups with combined spinal and epidural anesthesia. Group R received intrathecal ropivacaine 10 mg, group RF received ropivacaine 10 mg and fentanyl 20μg, group RT received ropivacaine 10 mg and tramdol 20 mg. The initial acting time, the degrees of sensory block and motor block were recorded. After cesarean section the time of complete analgesia, the time of efficient analgesia, VAS score of the most painful feeling and complications as headache, nausea were recorded. Results There were great differences among the three groups in the initial acting time, time of complete analgesia, time of efficient analgesia and VAS score of the most painful feeling after cesarean section, but no significant differences between group RF and group RT, respectively. Conclusion Ropivacaine combined with tramdol for spinal anesthesia in parturients undergoing cesarean section provides a satisfactory analgesic effect and prolongs the period of postoperative analgesia. （Shanghai Med J, 2006, 29：644-647）
出处
《上海医学》
CAS
CSCD
北大核心
2006年第9期644-647,共4页
Shanghai Medical Journal
