剖宫产椎管内麻醉中罗哌卡因的最佳使用剂量
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Intrathecal Ropivacaine in Cesarean Delivery
背景与目的
本研究通过比较剖宫产麻醉中不同剂量1%罗哌卡因的麻醉效果，从而探讨其对产妇的影响及最佳使用剂量。
方 法
共纳入60例ASA分级I-II级于椎管内麻醉下行择期剖宫产的产妇，随机分为三组：Group1：所有产妇接受1%罗哌卡因15mg；Group2：所有产妇接受1%罗哌卡因20mg；Group3：所有产妇接受1%罗哌卡因25mg.
结 果
三组间术中血流动力学无明显差异；三组间感觉阻滞及达峰时间、运动阻滞及达峰时间明显无差异；与其他两组相比，Group3的感觉阻滞时间维持更长（P＜0.05）；高剂量罗哌卡因组运动阻滞时间维持更长，但这种差异无统计学意义。
结 论
罗哌卡因麻醉起效快且能够产生满意的麻醉效果，15或20mg罗哌卡因椎管内麻醉即可达到满意的麻醉效果。
原始文献摘要
Ateser R Y, Kayacan N. Intrathecal ropivacaine in cesarean delivery.[J]. Nigerian Journal of Clinical Practice, 2017, 20(10):1322.
Objective:
The aim of the present study was to evaluate the optimum dose of ropivacaine by comparing three different dosing regimens of isobaric ropivacaine 1% (naropin 10 mg/ml, Astra Zeneca) administered intrathecally and to demonstrate the effects of anesthesia in pregnant women scheduled for cesarean section.
Patients and Methods:
Sixty ASA grade I-II patients were scheduled to undergo elective cesarean sections under spinal anesthesia. The patients were randomly assigned into three groups. Group 1 received 15 mg ropivacaine 1%, Group 2 received 20 mg ropivacaine 1%, and Group 3 received 25 mg ropivacaine 1%.
Results：
Intraoperative hemodynamic variables were not significantly different between the three groups, and sensory block time, motor block time and time to reach maximal sensory block time, and motor block time were similar between the three groups. The time to two-segment regression of sensory block was longer in Group 3 compared to other groups, and the difference was statistically significant (p < 0.05). The motor block time was longer with higher doses of ropivacaine; however, the difference was not statistically significant.
Conclusion:
Ropivacaine administration produced rapid induction of anesthesia and satisfactory anesthesia level, ropivacaine 15 mg and 20mg dosing regimens are satisfactory for spinal anesthesia.
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