剖宫产中盐酸罗哌卡因复合舒芬太尼腰硬联合阻滞的临床观察.docVIP

剖宫产中盐酸罗哌卡因复合舒芬太尼腰硬联合阻滞的临床观察 汤炎华（江苏常州武进区横林人民医院麻醉科 213101） 【摘要】目的盐酸罗哌卡因和舒芬太尼蛛网膜K腔麻醉应用在剖宫产屮常 有报道，本文R在探讨低剂量盐酸罗脈卡因复合低剂量舒芬太尼腰硬联合麻醉在 剖宫产屮应用的临床效果。方法选择我院接受腰硬联合麻醉剖宫产手术的初产 妇的60例，随机分为罗哌卡因组（R组）和布比卡因组（B组），分别给予罗哌 卡因10mg或布比卡因6.6mg,复合3.3ug的舒芬太尼。比较两组的感觉运动神 经阻滞，血流动力学以及新生儿结果。结果2组产妇生命体征，血流动力学, 新生儿Apgar评分、差异无统计学意义；与B组相比，R组几乎无运动阻滞，手 术时间更长，产妇满意度更高。结论低剂量盐酸罗脈卡因复合舒芬太尼腰硬联 合阻滞用于剖宫产无运动阻滞，安全有效。 【关键词】腰硬联合麻醉剖宫产罗哌卡因舒芬太尼 【屮图分类号】R969 【文献标识码】A 【文章编号】1672-5085 （2013） 31-0168-02 Combined spinal-epiduR21l anesthesia of ropavacaine and sufentanil for cesarean delivery [AbstR21ct] Objective:Ropivacaine have been studied for intR21thecal use during cesarean section in combination with sufentanil. The purpose of the present study was to research ropivacaine and sufentanil in low doses and in cesarean section.Methods:During the study of combined spinal-epiduR21l anesthesia, 60 Cesarean section patients were R21ndomly assigned to receive a spinal injection of either lOmg ropivacaine or 6.6mg bupivacaine both combined with sufentanil 3.3mu;g. The two local anesthetics were compared with respect to sensory and motor block,the severity of hypotension and neonatal outcome.Result:More patients in bupivacaine had a Bromage-3 motor block at incision, the interval between the spinal injection and the end of surgery is longer in the ropivacaine group. Hemodynamic values were compaR21ble,there is no difference between the study groups in systolic blood pressures and the incidence of severe hypotension,Apgar scores did not differ. Conclusion:When performing a low-dose combined spinal-epiduR21l anesthesia for cesarean section, ropavacaine and sufentanil can be used safely and successfully [Keywords] combined spinal-epiduR21l anesthesia cesarean ropivacaine sufentanil 罗哌卡因是长效酰胺类局部麻醉药，具奋高度的感觉运动神经阻滞分离性, 对中枢和心脏毒性低，剖宫产中鞘内单独使用剂量为27mg[l],比鞘内单用布比卡 因的剂量高。多项研究显示超过布比卡因50%剂量的罗脈卡因能表现出与布比卡 因类似的感觉运动阻滞特性[2-4]。舒芬太尼镇痛效应强，经鞘内给药可减少术中 麻醉药用量，有效预防术中应激反应，使血流动力学变化更稳定[5-6]。本研究通 过观察罗哌卡因和布比卡因分别联用舒芬太尼，观察鞘内低剂量罗哌卡因复合舒 芬太尼的有效性和安全性。 1资料与方法 1.1 一般资料：选择20