摘要
目的观察剖宫产术行腰硬联合左布比卡因改善肌肉松弛程度的效果。方法选取2021年5月-2022年5月在我院行剖宫产的84例产妇为研究对象,采用随机数字表法分为对照组和观察组,各42例。对照组采用腰硬联合罗哌卡因麻醉,观察组采用腰硬联合左布比卡因麻醉,比较两组麻醉起效时间、苏醒时间、麻醉优良率、肌肉松弛程度、疼痛分级、麻醉前和麻醉5 min后平均动脉压(MAP)、心率(HR)以及不良反应发生率。结果观察组麻醉起效时间、苏醒时间均短于对照组(P<0.05);观察组麻醉优良率与对照组比较,差异无统计学意义(P>0.05);观察组肌松完全率高于对照组(P<0.05),肌松一般率低于对照组(P<0.05),两组肌松不全率比较,差异无统计学意义(P>0.05);观察组疼痛0级占比高于对照组,1级占比小于对照组(P<0.05),2级占比与对照组比较,差异无统计学意义(P>0.05);观察组麻醉5 min后MAP、HR均高于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05)。结论在剖宫产术中,左布比卡因联合腰硬可获得与罗哌卡因相似的麻醉效果,但左布比卡因起效和苏醒时间短,肌肉松弛效果好,疼痛度低,对生命体征影响较小,且不良反应发生率低,具有良好的应用效果和安全性,值得临床应用。
Objective To observe the effect of lumbar epidural combined with levobupivacaine on improving muscle relaxation in cesarean section.Methods A total of 84 parturients who underwent cesarean section in our hospital from May 2021 to May 2022 were selected as the research objects.They were divided into control group and observation group by random number table method,with 42 parturients in each group.The control group was given spinal-epidural anesthesia combined with ropivacaine,and the observation group was given spinal-epidural anesthesia combined with levobupivacaine.The onset time of anesthesia,recovery time,excellent and good rate of anesthesia,degree of muscle relaxation,pain grading,mean arterial pressure(MAP)before anesthesia and 5 min after anesthesia,heart rate(HR)and incidence of adverse reactions were compared between the two groups.Results The onset time and recovery time of anesthesia in the observation group were shorter than those in the control group(P<0.05).There was no significant difference in the excellent and good rate of anesthesia between the observation group and the control group(P>0.05).The complete rate of muscle relaxation was higher than that in the control group,and the general rate of muscle relaxation in the observation group was lower than in the control group(P<0.05).The proportion of pain grade 0 in the observation group was higher than that in the control group,and the proportion of grade 1 was lower than that in the control group(P<0.05),while there was no significant difference in the proportion of grade 2 between the observation group and the control group(P>0.05).After 5 min of anesthesia,MAP and HR in the observation group were higher than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion In cesarean section,levobupivacaine combined with spinal epidural anesthesia can obtain similar anesthetic effect as ropivacaine,but levobupivacaine has short onset and recovery time,good muscle relaxation effect,low pain degree,less impact on vital signs,and low incidence of adverse reactions.Meanwhile,it has good application effect and safety,and is worthy of clinical application.
作者
王颖
吴金华
张金婷
WANG Ying;WU Jin-hua;ZHANG Jin-ting(Department of Obstetrics,Poyang County People's Hospital,Poyang 333100,Jiangxi,China)
出处
《医学信息》
2023年第22期78-81,共4页
Journal of Medical Information
基金
2021年社会发展领域市级科技计划医疗卫生指导性项目(编号:2021CZDX128)。
关键词
剖宫产术
腰硬联合
左布比卡因
肌肉松弛程度
Cesarean section
Combined lumbar-epidural
Levobupivacaine
Degree of muscle relaxation
