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1、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冯清华何文华廖小谊巢月娥【摘要】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50s。观察（1）感觉阻滞平面到达T10的时间和最高感觉阻滞平面；（2）进行麻醉质量评价；（3）运动阻滞评级；（4）蛛网膜下腔注药后5，10，15分钟BP、HR
2、、SPO2变化，并与基础值对比；（5）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15分钟所测到的血压值最低，与基础值比较A组明显(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理想，减慢输注速度对血流动力学影响更小。【
3、关键词】罗哌卡因腰-硬联合麻醉剖腹产麻醉效果血流动力学RopivacainespinalandepiduralanesthesiaoncesareansectionrateofdifferentinjectionanesthesiaandhemodynamicsFENGQing-huaLIAOXiao-YiHEWen-Hua.(CountyPeople'sHospital,Guangzhou,GuangdongProvince526300.CHINA【Abstract】ObjectiveTocompareropi
4、vacainespinalandepiduralanesthesiaduringcesareansectionwithdifferentinjectionrateonanesthesiaandhemodynamics.Methods180casesofcesareansectionintermpregnancywererandomlydividedintotheABCthreegroupsof60cases,L2～3intervertebraldiscpuncture,punctureafterthesucces
5、softhesubarachnoidinjectionof0.5%广东省广宁县人民医院526300ropivacaine2ml.,Injectionspeed:Agroupforthe15s,Bgroup,35s,Cgroup50s.Observation(1)toreachT10sensoryblockoftimeandpeaksensoryblock;(2)toevaluatethequalityofanesthesia;(3)motorblockrating;(4)aftersubarachnoidinje
6、ction5,10,15minutesofBP,HR,SPO2changesAndcomparedwithbaseline;(5)nauseaandvomiting,neurologicalcomplicationsandothersideeffects.ResultsofsensoryblockreachedT10timeAgroupandBgrouparesimilar(P＞0.05),BgroupfasterthantheCgroup(P＜0.01);thehighestgrouphadthehighest
7、sensoryblockA,Cgroupwasthelowest;anesthesiaQualityAssessment3groupsaregood;motorblockwerethree2min;threegroups15minutesafterinjection,thelowestbloodpressuremeasured,withvaluesAweresignificantly(P＜0.05),BgroupandCgroupalsodecreasedtoacertainextent(P＞0.05);onHR
8、andSPO2noImpact;nonausea,vomitingandneurologicalcomplications.Conclusionropivacainespinalandepiduralanesthesiaforcesareansectionofthreeinjectionrateoftheidealanestheticeffect,slowingthera
