CAJ | 학술논문

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。
목적：비교0.5%화0.375%경비중라고잡인요경연합마취용우부궁산술마취적효과。방법장의행부궁산적산부232례수궤분위A조（요마약위0.5%염산라고잡인）화B조（요마약위0.375%염산라고잡인），매조116례。기록마취전、절피시、태인면출후5 min적심솔（HR）、수축압（SBP）、서장압（DBP），관찰산부술중적혈관활성약、보조약，기록술자、산부만의솔。결과량조산부재마취전、태인면출후5 min적SBP、DBP비교차이무통계학의의（P>0.05）；량조재절피시적SBP、DBP、HR화태인면출후5 min적HR비교차이유통계학의의（P<0.05）；A조혈관활성약용량다우B조（P<0.05）；A조술자만의솔고우B조（P<0.05）。결론0.5%화0.375%라고잡인요경연합마취행부궁산도시안전유효적마취농도，량충농도진통효과호，전자대순배적영향교대，단기송효과교호，술자만의솔고，시요경연합마취중교괄당적마취농도。
Objective To compare the anesthesia effect of 0. 5% and 0. 375%light weight ropivacaine cesarean section in combined spinal lepidural anesthesia. Methods The 232 pregnant women schedule for cesarean section were randomly divided into group A(lumbar anesthesia was 0. 5%hydrochochloric acid ropivacaine)and group B(lumbar anesthesia was 0. 375%hydro-chloric acid ropivacaine),with 116 cases in each group. The HR and SBP,DBP successively before anesthesia,skin incision and 5 mins after fetal delivery were all recorded. The vascular active drugs and the adjuvant drug in the active medicine were ob-served,and the satisfaction rate of performer and maternal was recorded. Results There were no statistically significant differ-ences between the two groups in SBP,DBP before anesthesia and 5 mins after fetal delivery(P>0. 05);While there were statis-tically significant differences between the two groups of SBP,DBP,HR over skin incision,and the HR also have significant differences when 5 min after fetal delivery(P<0. 05);Group A used more vascular active drug dosage than group B(P <0. 05);The performer satisfaction of group A was higher than that of group B(P<0. 05). Conclusion 0. 5%or 0. 375%hydro-chloric acid ropivacaine are both safe and effective anesthetic concentration in combined spinal epidural anesthesia during cesare-an section. The analgesic effect are both good,but the former has bigger impact on blood circulation,but it also has better mus-cle relaxant and higher satisfaction rate,so it is more reasonable for the combined spinal epidural anesthesia.