| 摘要: |
| 目的 探讨罗哌卡因用于剖宫产术蛛网膜下腔阻滞的合理注药速度。方法 选择行剖宫产术产妇90 例，按蛛网膜
下腔阻滞时罗哌卡因注药时间采用随机数字表法分为30s 组、60s 组、90s 组，每组各30例。观察并记录麻醉前（T0）、麻醉后1min（T1）、5min（T2）、10min（T3）、20min（T4）收缩压（SBP）、舒张压（DBP）、心率（HR）变化，术中恶心、呕吐、胸闷、麻黄碱、阿托品使用例数，麻醉最高平面情况。结果 与60s 组、90s 组相比，30s 组SBP、DBP、HR 下降更为显著，发生恶心、呕吐、胸闷等不良反应及使用麻黄碱例数显著增多（P＜0.05）。30s 组、60s 组、90s 组产妇麻醉平面达T6以上分别为29 例、29 例、28例，均能满足手术要求，最高阻
滞平面达T4、T2的例数30s 组显著多于60s 组、90s 组（P＜0.05）。结论 常规剂量罗哌卡因用于蛛网膜下腔阻滞下剖宫产术，其注药时间宜控制在60～90s，同样能满足手术需要，且可减少不良反应的发生，而不是传统方法的15～30s。 |
| 关键词: 罗哌卡因 腰硬联合麻醉 蛛网膜下腔阻滞 剖宫产 |
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| Investigating injection speed of ropivacaine for subarachnoid block in cesarean section |
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WANG Zhibo, ZHENG Xiaoyu, ZHANG Miaofag
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Shenzhou People's Hospital
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| Abstract: |
| Objective To investigate the injection speed of ropivacaine for subarachnoid block in cesarean section.Methods Ninety patients undergoing cesarean section were randomly divided into three groups with 30 cases in each group: the injection time of ropivacaine for subarachnoid block in 3 group was 30s, 60s and 90s, respectively. The systolic blood pressure(SBP), diastolic blood pressure (DBP), heart rate (HR), nausea and vomiting, chest tightness, case number of ephedrine use, the
highest planes of anesthesia before anesthesia (T0), 1min (T1), 5min (T2), 10min (T3) and 20min (T4) after anesthesia were observed and recorded. Results compared with the 60s and 90s groups, the SBP, DBP, HR in 30s group decreased significantly and the occurrence of nausea and vomiting, chest tightness and other adverse reactions, and the number of cases of ephedrine use increased
significantly(P＜0.05). The numbers of cases with the anesthesia plane reaching T6` level in 30s, 60s and 90s groups were 29, 29 and 28 cases, indicating that three injection times were all meeting the operation requirements. The number of cases with maximum block plane reaching T4, T2 levels in 30s group was significantly more than those in 60s and 90s groups (P＜0.05).Conclusion The injection time of ropivacaine with conventional dose for subarachnoid block in cesarean section should be controlled in 60~90s, which can meet operational requirement and reduce the adverse reaction. |
| Key words: Ropivacaine Combined spinal-epidural anesthesia Subarachnoiod block Cesarean section |
