不同剂量舒芬太尼与罗哌卡因复合硬膜外麻醉在剖宫产术中的应用

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1、麗摄;罗脈卡因复合耐卜术中的娜2018-03-2001:26:12中国现代医生2018年1期阮北燕陈淸娟陈健陈宏才［摘耍］鬥的探討不同剂fi舒芬太尼与罗哌卡因复合硬膜外麻醉在剖宫产术屮的应用。方法选择在我院住院并行剖宫产手术的孕妇90例。随机分力三组，三组患者均采用硬膜外麻醉，A组的麻醉药物采用0.75%罗哌卡因10mL,B组麻醉药物采用0.75%罗哌卡因10mL与舒芬太尼10pg,C组麻醉药物采用0.75%罗哌卡因10mL与舒芬太尼20pg。观察并比较三组产妇的感觉阻滞起效时间、运动阻滞起效时间、镇痛持续时间、卜‘肢运动祌经HI

2、滞程度、术中肌松等级、取胎时VAS疼痛评分情况及不良反应，同时观察娩山时新生儿Apgar评分。结果B组与C组感觉阻滞起效时间、运动阻滞起效时间均快于A组(P<0.05或P<0.01),而C组较巳组起效更快(P<0.05)；B组与C组镇痛持续吋间均长于A组(P<0.05或P<0.01)，而B组与C组镇痛持续吋间相当(P>0.05)；B组与C组取胎时VAS评分均低于A组(P<0.05或P<0.01)，而C组较B组VAS评分更低(P<0.05)；三组孕妇巳romage评分、术中肌松评分、新生儿娩出1min,5min时Apgar评分、术后

3、并发症两两比较无统计学差异(P>0.05)。结论采用0.75%罗哌卡因复合20Mg舒芬太尼能取得最好的麻醉效果，产妇感觉与运动阻滞快、镇痛持续时间长、取胎时VAS低，不良反应少。［关键词］剖宮产；舒芬太尼；罗哌卡因；硬膜外麻醉［中图分类号］R614［文献标识码］B［文章编号】1673-9701(2018)01-0107-04ApplicationofdifferentdosesofsufentanilandropivacainecombinedwithepiduralanesthesiaincesareansectionRUANB

4、eiyanlCHENQingjuan2CHENJian2CHENHongcai31.DepartmentofAnesthesiology,TaizhouCentralHospitalinZhejiangProvince，TaizhouUniversityHospital,Taizhou318000，China；2.DepartmentofAnesthesiology,TaizhouEnzeMedicalCenter(Group)TaizhouHospitalAffiliatedMaternityHospitalinZhejiang

5、Province,Taizhou318000，China；3.DepartmentofAnesthesiology,TaizhouEnzeMedicalCenter(Group)LuqiaoHospital,Taizhou318050,China［Abstract］ObjectiveToinvestigatetheapplicationofdifferentdosesofsufentanilandropivacainecombinedwithepiduralanesthesiaincesareansection.MethodsAt

6、otalof90pregnantwomenwhowerehospitalizedinourhospitalandreceivedcesareansectioninourhospitalwereselected.Theywererandomlydividedintothreegroups，andthreegroupsofpatientswereallgivenepiduralanesthesia.TheanestheticsingroupAwas10mL0.75%ropivacaine，theanestheticsingroupBw

7、as10mL0.75%ropivacaineand10pgsufentanil，andtheanestheticsingroupCwas10mL0.75%ropivacaineand20pgsufentanil.Theonsettimeofsensoryblock,theonsettimeofexerciseblock，thedurationofanalgesia,thedegreeofmotornerveblockoflowerextremity,thedegreeofmusclerelaxation,theVASpainsco

8、resuponfetustakingandadversereactionswereobservedandcomparedamongthethreegroups，andatthesametime，theneonatalApgarscorewasobs