CAJ | 학술논문

目的：比较罗哌卡因腰-硬联合麻醉时不同注药速度对剖腹产麻醉效果及血流动力学的影响。方法180例足月妊娠剖腹产病人随机分为ABC三组，每组60例， L2～3椎间隙穿刺，穿刺成功后向蛛网膜下腔注入0.5％罗哌卡因2ml，注药速度： A组为15s， B组为35s， C组为50 s。观察⑴感觉阻滞平面到达T10的时间和最高感觉阻滞平面；⑵进行麻醉质量评价；⑶运动阻滞评级；⑷蛛网膜下腔注药后5，10，15min BP、 HR、 SPO2变化，并与基础值对比；⑸恶心呕吐，神经并发症等副作用。结果感觉阻滞平面到达T10的时间A组和B组相近（ P ＞0.05）， B组快于C组（ P ＜0.01）；最高感觉阻滞平面A组最高， C组最低；麻醉质量评价三组都优良；运动阻滞三组均为2分；三组注药后15min所测到的血压值最低，与基础值比较A组差异有统计学意义（ P ＜0.05）， B组和C组也有一定下降（ P ＞0.05）；对HR和SPO2无明显影响；无恶心呕吐和神经并发症出现。结论罗哌卡因腰硬联合麻醉时三种注药速度用于剖腹产手术麻醉效果均理想，减慢输注速度对血流动力学影响更小。
목적：비교라고잡인요-경연합마취시불동주약속도대부복산마취효과급혈류동역학적영향。방법180례족월임신부복산병인수궤분위ABC삼조，매조60례， L2～3추간극천자，천자성공후향주망막하강주입0.5％라고잡인2ml，주약속도： A조위15s， B조위35s， C조위50 s。관찰⑴감각조체평면도체T10적시간화최고감각조체평면；⑵진행마취질량평개；⑶운동조체평급；⑷주망막하강주약후5，10，15min BP、 HR、 SPO2변화，병여기출치대비；⑸악심구토，신경병발증등부작용。결과감각조체평면도체T10적시간A조화B조상근（ P ＞0.05）， B조쾌우C조（ P ＜0.01）；최고감각조체평면A조최고， C조최저；마취질량평개삼조도우량；운동조체삼조균위2분；삼조주약후15min소측도적혈압치최저，여기출치비교A조차이유통계학의의（ P ＜0.05）， B조화C조야유일정하강（ P ＞0.05）；대HR화SPO2무명현영향；무악심구토화신경병발증출현。결론라고잡인요경연합마취시삼충주약속도용우부복산수술마취효과균이상，감만수주속도대혈류동역학영향경소。
Objective To find effects of anesthesia and hemodynamics by different injection speeds in spinal and epidural anesthesia with ropivacaine on cesarean section .Methods One hundred and eighty cases of cesarean section in term pregnancy were randomly divided into three groups of 60 cases, L2 ~3 in-tervertebral disc puncture , puncture after the success of the subarachnoid injection of 0.5% ropivacaine 2ml.Injection speed:A group for the 15s, B group, 35s, C group 50s.Observation⑴to reach T10senso -ry block of time and peak sensory block;⑵to evaluate the quality of anesthesia ;⑶ motor block rating;⑷after subarachnoid injection 5,10,15 minutes of BP, HR, SPO2 changes, and compared with baseline;⑸nausea and vomiting , neurological complications and other side effects .Results Of sensory block reached T10 time A group and B group were similar ( P >0.05 ) , B group faster than the C group ( P <0.01 );the highest group had the highest sensory block A , C group was the lowest;anesthesia Quality Assessment 3 groups were good;motor block were three 2 min;three groups 15 minutes after injection , the lowest blood pressure measured , with values A were significantly ( P <0.05 ) , B group and C group also decreased to a certain extent ( P >0.05); on HR and SPO2 noImpact; no nausea, vomiting and neurological complica-tions.Conclusion Three speeds of ropivacaine injection are ideal .