Analysis of influence of anesthetic effect, maternal and infant outcomes and safety of subarachnoid block using sulfentanyl combined with ropivacaine for patients with gestational hypertension in the cesarean section
10.3760/cma.j.issn.1008-6706.2017.09.018
- VernacularTitle:苏芬太尼联合罗哌卡因蛛网膜下腔阻滞对妊娠期高血压疾病剖宫产术麻醉效果、母婴结局及安全性的影响
- Author:
Shuxiong ZHA
;
Yueqin YANG
;
Chao JIANG
- Keywords:
Hypertension,Pregnancy-Induced;
Sulfentanyl;
Ropivavaine;
Subarachnoid Space;
Nerve Block
- From:
Chinese Journal of Primary Medicine and Pharmacy
2017;24(9):1356-1361
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the influence of anesthetic effect,maternal and infant outcomes and safety of subarachnoid block used sulfentanyl combined with ropivacaine for patients with gestational hypertension in the cesarean section.Methods 180 cases of gestational hypertension ready to cesarean section were selected as study subjects,and they were randomly divided into A group,B group and C group by digital table method,60 cases in each group.A group used 10mg ropivacaine,B group used 13mg ropivacaine,C group used 5μg sulfentanyl combined with 10mg ropivacaine.The anesthetic effect,circulation function,duration of pain,operation time,neonatal Apgar score at 1 and 5 min after birth,neonatal weight,motor block evaluation after operation,adverse reaction and complication were compared in three groups.Results The anesthetic effect between B group and C group had no statistical difference (x2 =1.233,1.465,all P ＞ 0.05).The anesthetic effect of B group and C group was better than that of A group(F =5.633,7.299,all P ＜0.05).The HR and MAP of every time points between A group and C group had no statisticaldifferences (F =1.313,1.265,all P ＞ 0.05).Compared with T0,the HR and MAP of B group at T1,T2,T3,T4 had statistical differences compared with A group and C group(F =5.633,7.299,all P ＜0.05).The operation time of the three groups had no statistical difference(F =0.933,P ＞ 0.05).The duration of pain between B group and C group had no statistical difference(t =0.822,P ＞ 0.05).The duration of pain of A group was longer than that of B group and C group(F =8.316,P ＜0.05).The neonatal Apgar scores at 1 and 5 min after birth and neonatal weight of the three group had no statistical differences(F =0.822,0.929,all P ＞ 0.05).The improved Bromage score between A group and C group had no statistical difference (t =2.627,1.991,all P ＞ 0.05).The improved Bromage score between B group and A,C group had statistical differences(F =6.371,5.693,all P ＜ 0.05).The complete recovery time of motor nerve of B group was much longer than that of A group and C group (F =8.924,P ＜ 0.05).The incidence rates of vomit and nausea of A group and B group were much higher than that of C group(F =3.561,12.581,all P ＜ 0.05).The incidence rate of bradycardia and hypotension of B group was much higher than that of A group and C group (F =8.273,10.833,all P ＜ 0.05).Conclusion During subarachnoid block anaethesia using 5 μg sulfentanyl combined with l0mg ropivacaine can be applied to mild and moderate gestational hypertension,it has advantages such as less adverse reaction,good analgesic effect,less hemodynamic effect,and it is worthy of clinical promotion.
