罗哌卡因复合小剂量舒芬太尼腰硬联合麻醉用于剖宫产瘢痕部位妊娠患者剖宫产术的效果观察
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摘要
目的:探讨罗哌卡因复合小剂量舒芬太尼腰硬联合麻醉用于剖宫产瘢痕部位妊娠患者剖宫产术的效果。方法:选取2016年4月至2018年7月黄冈市中心医院收治的剖宫产瘢痕部位妊娠拟行剖宫产术患者94例,按照随机数字表法分为对照组与观察组,每组47例。对照组患者给予罗哌卡因,观察组患者给予罗哌卡因复合小剂量舒芬太尼。对比两组患者的阻滞效果及产后不良反应发生情况的差异。结果:观察组患者的感觉、运动阻滞起效时间和运动阻滞维持时间明显短于对照组,感觉阻滞维持时间明显长于对照组,差异均有统计学意义(P<0.05);观察组患者产后不良反应发生率为10.6%(5/47),明显低于对照组的38.3%(18/47),差异有统计学意义(P<0.05)。结论:罗哌卡因复合小剂量舒芬太尼腰硬联合麻醉可显著加快剖宫产瘢痕部位妊娠患者行剖宫产术时的麻醉速度,延长感觉阻滞的维持时间,提高手术镇痛效果,并减少产后不良反应。
OBJECTIVE:To probe into the effects of ropivacaine combined with low dose of sufentanil for combined spinal-epidural anesthesia in cesarean scar pregnancy. METHODS:94 patients with cesarean scar pregnancy admitted into Huanggang Central Hospital from Apr. 2016 to Jul. 2018 were selected and divided into control group and observation group via random number table, with 47 cases in each group. The control group was given ropivacaine, while the observation group was given ropivacaine combined with low dose of sufentanil. Comparison of blocking effects and incidences of postpartum adverse drug reactions between two groups were compared. RESULTS:The onset time of sensory and motor blocking and the maintenance time of motor blocking of observation group were significantly shorter than those of the control group, the maintenance time of sensory blocking of observation group was significantly longer than that of the control group, with statistically significant differences(P<0.05); the incidence of postpartum adverse drug reactions of observation group was 10.6%(5/47), which was significantly lower than that of the control group(38.3%, 18/47), with statistically significant difference(P<0.05). CONCLUSIONS:The combination of ropivacaine and low dose of sufentanil for combined spinal anesthesia can significantly accelerate the anesthesia speed in operation of cesarean scar pregnancy, prolong the maintenance time of sensory blocking, improve analgesic effect and reduce postpartum adverse drug reactions.
OBJECTIVE:To probe into the effects of ropivacaine combined with low dose of sufentanil for combined spinal-epidural anesthesia in cesarean scar pregnancy. METHODS:94 patients with cesarean scar pregnancy admitted into Huanggang Central Hospital from Apr. 2016 to Jul. 2018 were selected and divided into control group and observation group via random number table, with 47 cases in each group. The control group was given ropivacaine, while the observation group was given ropivacaine combined with low dose of sufentanil. Comparison of blocking effects and incidences of postpartum adverse drug reactions between two groups were compared. RESULTS:The onset time of sensory and motor blocking and the maintenance time of motor blocking of observation group were significantly shorter than those of the control group, the maintenance time of sensory blocking of observation group was significantly longer than that of the control group, with statistically significant differences(P<0.05); the incidence of postpartum adverse drug reactions of observation group was 10.6%(5/47), which was significantly lower than that of the control group(38.3%, 18/47), with statistically significant difference(P<0.05). CONCLUSIONS:The combination of ropivacaine and low dose of sufentanil for combined spinal anesthesia can significantly accelerate the anesthesia speed in operation of cesarean scar pregnancy, prolong the maintenance time of sensory blocking, improve analgesic effect and reduce postpartum adverse drug reactions.
引文
[1] 石立云.腰麻联合硬膜外麻醉应用于剖宫产术的临床麻醉疗效观察[J].世界最新医学信息文摘,2018,82(82):65.
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[8] 叶娟,尹文静.腰硬联合麻醉对剖宫产术产妇妊娠结局的影响效果分析[J].世界最新医学信息文摘,2018,18(74):88.
[9] 杜顺颜,林金兵,邓爱红,等.剖宫产硬膜外腔单次注射吗啡联合舒芬太尼静脉自控镇痛对产后抑郁的影响[J].中国药业,2018,27(17):69-71.
[10] 吴小唤.小剂量布比卡因复合芬太尼腰硬联合麻醉在急诊剖宫产的临床应用[J].中外女性健康研究,2018(17):46,52.
[11] 闫健吏,王秋筠.羟考酮用于子宫动脉栓塞术终止瘢痕妊娠的镇痛效果[J].解放军医学院学报,2018,39(1):28-30.
[12] 吕兰,陶刚,邓洁,等.再次妊娠的瘢痕子宫行剖宫产不同麻醉方式效果比较[J].临床医药文献电子杂志,2017,4(36):6942,6944.
[13] 孙绍敏.腹腔镜手术治疗剖宫产术后子宫瘢痕部位妊娠临床分析[J].中国实用医药,2017,12(8):72-74.
[14] 谢言虎,凡小庆,高燕春,等.瘢痕子宫合并前置胎盘剖宫产麻醉回顾性分析[J].临床麻醉学杂志,2015,31(10):1026-1028.
[2] 胡乃光,王莉萍,王艳粉,等.瑞芬太尼剂量差异复合七氟醚对行全身麻醉剖宫产患者血流动力学的影响[J].中国合理用药探索,2018,15(10):52-56.
[3] 李衔强.布托啡诺复合罗哌卡因用于硬膜外麻醉剖宫产术的临床观察[J].世界最新医学信息文摘,2018,18(78):41-42.
[4] 董慧芹.舒芬太尼硬膜外麻醉结合盐酸罗哌卡在无痛分娩中的临床应用效果研究[J].中国医药指南,2018,16(26):87.
[5] 李成,张新民,杨涛,刘峰.两种不同的椎管内麻醉在剖宫产手术中的效果对比[J].世界最新医学信息文摘,2018,18(75):36-37.
[6] 刘仁毅.分析低剂量布比卡因联合芬太尼腰麻在剖宫产术中的应用效果[J].世界最新医学信息文摘,2018,18(75):66-67.
[7] 吁诚铭,陈燕,徐国铖.罗哌卡因应用于剖宫产术的麻醉效果评价相关指标探讨[J].继续医学教育,2019,33(1):130-132.
[8] 叶娟,尹文静.腰硬联合麻醉对剖宫产术产妇妊娠结局的影响效果分析[J].世界最新医学信息文摘,2018,18(74):88.
[9] 杜顺颜,林金兵,邓爱红,等.剖宫产硬膜外腔单次注射吗啡联合舒芬太尼静脉自控镇痛对产后抑郁的影响[J].中国药业,2018,27(17):69-71.
[10] 吴小唤.小剂量布比卡因复合芬太尼腰硬联合麻醉在急诊剖宫产的临床应用[J].中外女性健康研究,2018(17):46,52.
[11] 闫健吏,王秋筠.羟考酮用于子宫动脉栓塞术终止瘢痕妊娠的镇痛效果[J].解放军医学院学报,2018,39(1):28-30.
[12] 吕兰,陶刚,邓洁,等.再次妊娠的瘢痕子宫行剖宫产不同麻醉方式效果比较[J].临床医药文献电子杂志,2017,4(36):6942,6944.
[13] 孙绍敏.腹腔镜手术治疗剖宫产术后子宫瘢痕部位妊娠临床分析[J].中国实用医药,2017,12(8):72-74.
[14] 谢言虎,凡小庆,高燕春,等.瘢痕子宫合并前置胎盘剖宫产麻醉回顾性分析[J].临床麻醉学杂志,2015,31(10):1026-1028.