0.75%罗哌卡因用于剖宫产术蛛网膜下腔阻滞的量效关系研究

中国临床药理学与治疗学 ›› 2008, Vol. 13 ›› Issue (9): 1017-1020.

0.75%罗哌卡因用于剖宫产术蛛网膜下腔阻滞的量效关系研究

高峰, 张细明, 宋立强

浙江宁波开发区中心医院麻醉科, 宁波315800, 浙江

收稿日期:2008-07-08 修回日期:2008-08-25 出版日期:2008-09-26 发布日期:2020-10-13
作者简介:高峰, 男, 本科, 副主任医师, 研究方向:临床麻醉及疼痛治疗、血液保护。Tel:13566365927 E-mail:gaofeng10@163.com

Dose-effect relationship of spinal anesthesia with 0.75% ropivacaine in caesarean section

GAO Feng, ZHANG Xi-ming, SONG Li-qiang

Department of Anesthesiology, Development Zone Central Hospital, Ningbo 315800, Zhejiang, China

Received:2008-07-08 Revised:2008-08-25 Online:2008-09-26 Published:2020-10-13

摘要/Abstract

摘要： 目的:观察0.75% 罗哌卡因用于剖宫产手术蛛网膜下腔阻滞的量效关系。方法:选择足月、单胎产妇120 例, 按蛛网膜下腔阻滞的用药量(0.75% 罗哌卡因原液) 随机分为4 组:Ⅰ 组为1.5 mL;Ⅱ组为1.8 mL;Ⅲ组为2.1 mL;IV 组为2.4 mL, 每组各30 例。观察注药后30 min 内各组患者的感觉和运动阻滞情况、血流动力学变化及相关的不良反应。结果:(1) I～IV 组注药后30 min 内的痛觉消失最高阻滞平面中位数分别为T₁₀、T₈、T₆ 和T₅ 。(2) 在观察的30 min 内, III 组有3 例(10%)、IV 组有8 例(27%) 出现胸闷和呼吸困难;III 组有5 例(17%)、IV 组有12 例(40%) 出现血压下降至90 mm Hg(1 mm Hg=0.133 kPa) 以下, I、II、III 组分别与IV 组比较差异有统计学意义(P<0.05) 。(3) 4 组的下肢运动阻滞(BromageⅢ级阻滞) 例数(率) 分别为3 例(10%)、6 例(20%)、10 例(33%) 和18 例(60%), 除I、II、III 组之间差异无统计学意义(P>0.05), IV 组与其余各组之间差异均有统计学意义(P<0.05) 。(4)III 组有4 例(13%)、IV 组10 例(33%) 发生仰卧位低血压综合征;III 组有4 例(13%)、IV 组有12例(40%) 出现心动过缓, 心率均降至55 次 min 以下。(5) I 组有8 例, II 组有3 例在手术切皮时仍有疼痛, III、IV 组麻醉效果良好且腹肌松弛。结论:0.75% 罗哌卡因原液1.8～2.1 mL 蛛网膜下腔阻滞用于剖宫产手术是安全有效的。

关键词: 罗哌卡因, 剖宫产, 蛛网膜下腔阻滞, 量效关系

Abstract: AIM: To observe dose-effect relationship of spinal anesthesia with 0.75% ropivacaine in caesarean section.METHODS: According to the dosage of 0.75% ropivacaine, 120 full-term and singlebirth puerperants were randomly divided into four groups of 30 people each.The dosage of group Ⅰ, Ⅱ, Ⅲ and Ⅳ were 1.5, 1.8, 2.1 and 2.4 mL respectively.The sensory and motor block of each group within 30 minutes after the injection were observed, and the hemodynamic changes and adverse effects were recorded.RESULTS: (1) Within 30minutes after the injection, the intermediate zone of pain disappeared highest block level of group I-IV were T₁₀, T₈, T₆ and T₅ respectively. (2) During the period of the first 30 minutes, there were 3 cases in group Ⅲ (10%) and 8 cases in group Ⅳ (27%) appeared chest distress and dyspnea, and the blood pressure of 5 cases in group Ⅲ (17%) and 12 cases in group Ⅳ (40%) dropped to 90 mm Hg (1 mm Hg=0.133 kPa).There were significant difference compared with group IV (P<0.05). (3) The cases (rate) of motor block of extremities inferior were 3 (10%), 6 (20%), 10 (33%) and 18 (60%) in the four groups respectively.Except that there was no significant difference between I, II, III groups (P>0.05), there were significant difference between group IV and other groups (P<0.05). (4) 4 cases in group Ⅲ (13%) and 10 cases in group Ⅳ (33%) appeared supine hypotensive syndrome, 4 cases in group Ⅲ (13%) and 12 in group Ⅳ (40%) appeared bradycardia. (5) 8 cases in group Ⅰ and 3 in group Ⅱ appeared pain during surgical incision, but group Ⅲ and Ⅳ showed excellent anesthetic effect and muscle relaxation.CONCLUSION: The dose-effect relationship of spinal anesthesia with 0.75% ropivacaine in caesarean section displayed that the dosage of 1.8～2.1 mL was safe and feasible.

Key words: ropivacaine, caesareansection, subarachnoidblock, dose-effectrelationship

中图分类号:

R614.2⁺4

高峰, 张细明, 宋立强. 0.75%罗哌卡因用于剖宫产术蛛网膜下腔阻滞的量效关系研究[J]. 中国临床药理学与治疗学, 2008, 13(9): 1017-1020.

GAO Feng, ZHANG Xi-ming, SONG Li-qiang. Dose-effect relationship of spinal anesthesia with 0.75% ropivacaine in caesarean section[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2008, 13(9): 1017-1020.

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