摘要
目的研究不同浓度罗哌卡因腰-硬联合麻醉对剖宫产产妇麻醉镇痛效果的影响,为产妇减轻疼痛及提高麻醉效果提供参考依据。方法选择80例接受剖宫产手术产妇,利用计算机随机排序分为A组、B组、C组和D组,各20例。每组分别给予0.4%、0.5%、0.6%、0.75%罗哌卡因各2 ml进行麻醉。比较四组产妇麻醉镇痛效果,麻醉阻滞效果评分(包括感觉最大阻滞平面、感觉阻滞见效时间、运动最大阻滞程度及运动阻滞见效时间)、Bromage评分及不良反应发生率。结果随着术后时间推移,各组产妇VAS评分均降低,其中A组评分与其他三组显著较高,差异具有统计学意义(P<0.05)。舒适度上A组在术后6 h低于其余三组,差异具有统计学意义(P<0.05)。四组麻醉阻滞效果比较差异无统计学意义(P>0.05)。A组、B组、D组术后24 h的Bromage评分均高于C组,差异有统计学意义(P<0.05),且A组、B组、D三组组间比较差异无统计学意义(P>0.05)。四组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在剖宫产腰-硬联合麻醉术中,使用浓度0.6%罗哌卡因对产妇具有明显的镇痛效用,同时使产妇保持较好的舒适度,降低术后不良反应发生率,整体应用效果要明显由于其余各个浓度,适宜进一步推广。
Objective To study the effect of combined lumbar-epidural anesthesia with different concentrations of ropivacaine on anesthesia and analgesia in pregnant women with cesarean section,so as to provide reference for reducing pain and improving anesthesia effect for puerperae.Methods 80 pregnant women who underwent cesarean section were randomly divided into group A,group B,group C and group D,20 cases in each group.Each group was anesthetized with 2 ml ropivacaine of 0.4%,0.5%,0.6% and 0.75%,respectively.The effects of anesthesia and analgesia,anesthesia block effect score(including the maximum sensory block plane,the effect time of sensory block,the maximum motor block degree and the effect time of motor block),Bromage score and the incidence of adverse reactions were compared among the four groups.Results With the passage of postoperative time,the VAS scores of puerpera in each group decreased,and the scores of group A were significantly higher than those of the other three groups,and the difference was statistically significant(P<0.05).The comfort level of group A was lower than that of the other three groups at 6 h after operation,and the difference was statistically significant(P<0.05).There was no significant difference in anesthetic block effect among the four groups(P>0.05).The Bromage score at 24 h after operation in groups A,B and D was higher than that in group C,and the difference was statistically significant(P<0.05),and there was no significant difference among groups A,B and D(P>0.05).There was no significant difference in the incidence of adverse reactions among the four groups(P>0.05),Conclusion In cesarean section combined spinal-epidural anesthesia,the use of ropivacaine with a concentration of 0.6% has obvious analgesic effect on puerperae,while maintaining good comfort for puerperae and reducing the probability of postoperative adverse reactions,the overall application effect should be obvious because of the remaining concentrations,it is suitable for further promotion.
作者
高小龙
范丽静
汤娟
吴海梅
卓凡
Gao Xiaolong;Fan Lijing;Tang Juan;Wu Haimei;Zhuo Fan(Department of Anesthesiology,Haifeng East Hospital,Haifeng 516400,China)
出处
《实用妇科内分泌电子杂志》
2022年第7期54-57,共4页
Electronic Journal of Practical Gynecological Endocrinology
基金
2021年度汕尾市科技计划项目(编号210603096340279)。
关键词
罗哌卡因
剖宫产手术
麻醉镇痛
Ropivacaine
Cesarean section operation
Anesthesia analgesic
