摘要
目的探究高比重和低比重罗哌卡因联合应用对脊髓麻醉剖宫产孕妇血流动力学特征的影响。方法选取我院2014年7月至11月行剖宫产孕妇116名,利用前瞻性、双盲、随机对照研究方法将其随机分成A、B两组,每组各58名。A组孕妇接受高、低比重罗哌卡因联合脊髓麻醉,B组只接受高比重罗哌卡因麻醉。观察并记录两组孕妇的血流动力学变化、感觉阻滞最高平面、达到T8感觉阻滞水平时间、并发症的发生率、1min和5min时的Apgar评分与新生儿血气分析。结果 A组孕妇的感觉阻滞水平明显低于B组(T6[T6-T7]vs T3[T2-T4]),达到T8感觉阻滞水平所需要的时间更长(8±2.0min vs 6±1.8min),且两组间差异具有显著统计学意义(P<0.001)。另外,A组孕妇低血压(15%vs 59%,P<0.001)、恶心(10%vs 41%,P=0.002)和呕吐(3%vs 18%,P=0.022)的发生率明显低于B组。结论高比重(4mg)和低比重(6mg)罗哌卡因联合使用通过延长麻醉诱导时间和降低感觉阻滞水平能明显降低剖宫产孕妇脊髓麻醉后低血压和并发症的发生率。
Objective To investigate the influence of the combined use of hyperbaric and hypobaric ropivacaine on the hemodynamic characteristics of parturients during spinal anesthesia for caesarean section.Methods Parturients（n=116）undergoing cesarean section in our hospital from July to November 2014 were chosen for this study.With the prospective,double-blind,randomized and controlled method,these parturients were randomly and equally divided into two groups（Group A and Group B）,and each group has 58 parturients.The parturients in Group A received the combined hyperbaric and hypobaric ropivacaine,and Group B received the hyperbaric ropivacaine.Then we observed and recorded their outcome measures,including hemodynamic changes,maximum height of sensory block,time to achieve T8 sensory blockade level,incidence of complications,Apgar scores at 1min and 5min,and neonatal blood gas analysis.Results Group A has the lower level of sensory blockade（T6[T6-T7]）and longer time to achieve T8 sensory blockade level（8±2.0min）than does parturients in Group B（T3[T2-T4]and 6±1.8min,P〈0.001）.The incidence rates for hypotension（15% vs 59%,P〈0.001）,nausea（10% vs 41%,P=0.002）,and vomiting（3% vs 18%,P=0.022）were significantly lower in Group A than Group B.Conclusion The combined use of hyperbaric（4 mg）and hypobaric（6mg）ropivacaine significantly decreased the incidences of hypotension and complications in spinal anesthesia for caesarean section by extending induction time and decreasing the level of sensory blockade.
出处
《中国实验诊断学》
2015年第12期2015-2018,共4页
Chinese Journal of Laboratory Diagnosis
基金
陕西省卫生科研项目(项目编号:2014-D27)
关键词
罗哌卡因
脊髓麻醉
剖宫产
血流动力学
ropivacaine
spinal anesthesia
caesarean section
hemodynamics
