CAJ | 학술논문

目的：观察小剂量盐酸罗哌卡因腰－硬联合麻醉对剖腹产孕妇血流动力学及麻醉质量的影响。方法132例行择期剖宫产术产妇随机分为试验组和对照组，每组各66例。均经L2－L3腰椎间隙行蛛网膜下腔穿刺麻醉，试验组给予0．75％罗哌卡因1 mL＋注射用水2 mL；对照组给予0．75％罗哌卡因2 mL＋注射用水1 mL，观察2组心率（HR）、平均动脉压（MAP）、血氧饱和度（SpO2）、麻醉平面固定时间、麻醉时间、肌松满意度和不良反应发生情况。结果麻醉前、麻醉15 min和手术结束后，2组HR、MAP、SpO2差异无统计学意义（ P＞0．05）。胎儿分娩后对照组HR（89．3±9．7） times? min－1明显增快，MAP（97．0±10．3） mmHg和SpO2（95．1±0．7）％明显降低（ P＜0．05）。2组产妇在麻醉平面、麻醉时间及肌松满意度比较差异无统计学意义（ P＞0．05）。试验组产妇麻醉苏醒时间（19．27±3．19） min 和自主排尿时间（18．42±2．12） h 均早于对照组（P＜0．05），2组新生儿娩出后1 min Apgar 评分比较差异无统计学意义（ P＞0．05）。试验组不良反应发生率（7．58％）显著低于对照组（28．79％， P＜0．05）。结论小剂量盐酸罗哌卡因腰－硬联合麻醉有助于剖宫产手术患者血流动力相对稳定，提高麻醉质量。
목적：관찰소제량염산라고잡인요－경연합마취대부복산잉부혈류동역학급마취질량적영향。방법132례행택기부궁산술산부수궤분위시험조화대조조，매조각66례。균경L2－L3요추간극행주망막하강천자마취，시험조급여0．75％라고잡인1 mL＋주사용수2 mL；대조조급여0．75％라고잡인2 mL＋주사용수1 mL，관찰2조심솔（HR）、평균동맥압（MAP）、혈양포화도（SpO2）、마취평면고정시간、마취시간、기송만의도화불량반응발생정황。결과마취전、마취15 min화수술결속후，2조HR、MAP、SpO2차이무통계학의의（ P＞0．05）。태인분면후대조조HR（89．3±9．7） times? min－1명현증쾌，MAP（97．0±10．3） mmHg화SpO2（95．1±0．7）％명현강저（ P＜0．05）。2조산부재마취평면、마취시간급기송만의도비교차이무통계학의의（ P＞0．05）。시험조산부마취소성시간（19．27±3．19） min 화자주배뇨시간（18．42±2．12） h 균조우대조조（P＜0．05），2조신생인면출후1 min Apgar 평분비교차이무통계학의의（ P＞0．05）。시험조불량반응발생솔（7．58％）현저저우대조조（28．79％， P＜0．05）。결론소제량염산라고잡인요－경연합마취유조우부궁산수술환자혈류동력상대은정，제고마취질량。
Objective To study the effect of small doses ropivacaine combined spinal epidural anesthesia on hemodynamic and anesthesia quality in cesarean section pregnant women.Methods A total of 132 cases pregnant women with cesarean section were divided into experimen-tal group and control group, all patients given L2, L3 lumbar line com-bined with spinal epidural anesthesia. Experimental group were given 0.75% ropivacaine 1 mL +2 mL water injection; control group given 0.75%ropivacaine 2 mL +1 mL water injection.Heart rate ( HR ) , mean artery pressure ( MAP ) , oxygen saturation ( SpO2 ) , anesthesia plane fixed time, anesthesia time, muscle relaxant satisfaction, adverse reactions were compared between the two groups.Results Before anes-thesia, 15 min after anesthesia and operation completed, there were no statistical significance of HR, MAP, SpO2 between the two groups (P>0.05).After fetal childbirth, HR (89.3 ±9.7) times? min-1 in control group was significantly faster, MAP (97.0 ±10.3) mmHg and SpO2(95.1 ±0.7)%significantly decreased (P<0.05).There were no statistical significance of anesthesia plane, anesthesia time, muscle relaxant between the two groups(P>0.05);mater-nal anesthesia awakening time (19.27 ±3.19) min and automatic micturition time (18.42 ±2.12) h in experimental group were shorter than those of control group ( P <0.05 ) .There was no statistical significance of neonatal 1 min Apgar score between the two groups ( P >0.05 ) .The incidence rate of adverse reactions in experimental group (7.58%) was significantly lower than that in control group(28.79%, P<0.05).Conclusion Small doses ropiva-caine combined with spinal epidural anesthesia helped hemodynamic of pregnant women to be relative stability, and could improve the quality of anesthesia.