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目的比较0.5%和0.375%轻比重罗哌卡因腰硬联合麻醉用于剖宫产术麻醉的效果。方法将拟行剖宫产的产妇232例随机分为A组(腰麻药为0.5%盐酸罗哌卡因)和B组(腰麻药为0.375%盐酸罗哌卡因),每组116例。记录麻醉前、切皮时、胎儿娩出后5 min的心率(HR)、收缩压(SBP)、舒张压(DBP),观察产妇术中的血管活性药、辅助药,记录术者、产妇满意率。结果两组产妇在麻醉前、胎儿娩出后5 min的SBP、DBP比较差异无统计学意义(P>0.05);两组在切皮时的SBP、DBP、HR和胎儿娩出后5 min的HR比较差异有统计学意义(P<0.05);A组血管活性药用量多于B组(P<0.05);A组术者满意率高于B组(P<0.05)。结论 0.5%和0.375%罗哌卡因腰硬联合麻醉行剖宫产都是安全有效的麻醉浓度,两种浓度镇痛效果好,前者对循环的影响较大,但肌松效果较好,术者满意率高,是腰硬联合麻醉中较适当的麻醉浓度。
Objective To compare the efficacy of 0.5% and 0.375% light-weight ropivacaine combined with epidural anesthesia in cesarean section anesthesia. Methods A total of 232 maternal women who underwent cesarean section were randomly divided into group A (0.5% ropivacaine hydrochloride for spinal anesthesia) and group B (0.375% ropivacaine for spinal anesthesia), with 116 cases in each group. The heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) at 5 min after anesthesia, skin incision, and vomiting were recorded before anesthesia. The vasoactive drugs, auxiliary drugs, recording technicians, maternal satisfaction rate . Results There was no significant difference in SBP and DBP between the two groups before anesthesia 5 min after delivery (P> 0.05). SBP, DBP and HR at the time of skin incision and HR at 5 min after delivery The difference was statistically significant (P <0.05). The amount of vasoactive drugs in group A was more than that in group B (P <0.05). The satisfaction rate in group A was higher than that in group B (P <0.05). Conclusion 0.5% and 0.375% ropivacaine combined with caesarean section in the combined spinal and epidural anesthesia are safe and effective anesthetic concentration, the two concentrations of analgesic effect is good, the former has a greater impact on the circulation, but the muscle relaxant effect is better, surgery The high rate of satisfaction is more appropriate anesthesia in spinal joint anesthesia.