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1、罗哌卡因在剖宫产手术腰硬联合麻醉患者中的应用效果目的分析罗哌卡因在剖宫产手术腰-硬联合麻醉患者中的应用效果。方法将我院2017年210月接诊的104例腰-硬联合麻醉下行剖宫产手术的产妇，按系统随机化法分为罗哌卡因组和布比卡因组，每组各52例。罗哌卡因组使用1.5 ml的0.5罗哌卡因作为麻醉药物，布比卡因组使用同等剂量同等浓度的布比卡因，对两组患者的神经阻滞时间、麻醉效果、不同时刻血流动力学差异及异常反应情况进行统计分析。结果罗哌卡因组感觉神经和运动神经阻滞出现时间晚于布比卡因组，持续时间短于布比卡因组，差异有统计学意义（P0.05）；罗哌卡因麻醉效果优于布比卡因（P0.05）;罗哌卡因组在给
2、药5和10 min后收缩压和平均动脉压均高于布比卡因组，差异均有统计学意义（P0.05）。结论对腰-硬联合麻醉下行剖宫产手术的产妇使用罗哌卡因麻醉比布比卡因的神经阻滞时间出现更晚、持续时间更短、麻醉效果更佳、对产妇血流动力学影响更小。AbstractObjective To analyze the effect of Ropivacaine on combined spinal-epidural anesthesia in cesarean section.Methods 104 patients undergoing cesarean section under combined spina
3、l-epidural anesthesia in our hospital from February to October 2017，were divided into Ropivacaine group （n=52） and Bupivacaine group （n=52） according to systic randomization.The Ropivacaine group was treated with 1.5 ml 0.5% Ropivacaine as the narcotic drug，and the Bupivacaine group was treated with
4、 the same dose and concentration of Bupivacaine.The nerve block time，anesthetic effect，hemodynamic difference at different times and abnormal reaction of the two groups were statistically analyzed.Results Starting time of sensory nerve and motor nerve block of the Ropivacaine group were later and du
5、ration were shorter than Bupivacaine group，the differences were statistically significant （ P 0.05）.The anesthesia effect of Ropivacaine was better than that of Bupivacaine （P0.05）.After 5 and 10 minutes of anaesthesia，the mean arterial pressure and systolic blood pressure of Ropivacaine group were
6、higher than that of Bupivacaine group ，the differences were statistically significant（P0.05）.Conclusion Starting time of nerve block of using Ropivacaine is later and duration is shorter than Bupivacaine in cesarean section under combined spinal-epidural anesthesia.Ropivacaine is more effective than
7、 Bupivacaine.It has less influence on hemodynamics of puerpera.Key wordsCombined spinal-epidural anesthesia；Cesarean section； Ropivacaine；Bupivacaine；Anesthesia effect；Hemodynamics腰-硬联合麻醉是一种结合腰麻与硬膜外麻醉优点并有效避免两者缺陷的联合麻醉方式1。目前临床上常用于腰-硬联合麻醉的麻醉剂包括布比卡因和罗哌卡因等2；布比卡因是一种临床上常用的长效且安全的麻醉剂，罗哌卡因是布比卡因的一种替代产物，其对感觉神经和运动神经具有不同程度的阻滞，尤其适
