妇产科用药专栏
LI Bulong;WU Kaihong;ZHAN Hong;CHEN Haowen
2002, 21(07): 404-405.
Objective:To evaluate the efficacy and safety of 1% ropivacaine versus 0.75% bupivacaine in combination with epidural anaesthesia (CSEA) for cesarean section. Methods:sixty primiparae (ASAⅠ～Ⅱ) scheduled for elective cesarean section were divided into three groups: ropivacaine group one (R1) received 1 mL of 1% ropivacaine, ropivacaine group two (R2) received 1.5 mL of 1% ropivacaine, and bupivacaine group (B) received 1.4 mL of 0.75% bupivacaine for lumbar anesthesia. During operation when lumbar anesthesia was inadequate, 2% lidocaine was supplemented via epidural catheter. Blood pressure, heart rate and SpO2 were monitored. Sensory block (pin prick), motor block (modified Bromage scale), quality of analgesia and relaxation of abdominal wall were assessed. Apgar score of the neonates and umbilical artery blood gas as well as side effects were recorded. Results:There was no significant difference among the three groups in age, height, body weight of the patients and duration of operation. The height of block was comparable between the three groups but the onset time was longer and duration of block shorter in ropivacaine groups. Motor block was weaker with ropivacaine than that with bupivacaine(P＜0.01). Comparaed with preoperation, MAP decreased more significantly during suture in groups R1 and R2 than that in group B(P＜0.05), HR increased significantly after delivery and decreased significantly during suture in groups R1 and R2(P＜0.05), MAP decreased significantly after delivery in group B(P＜0.05). Analgesia and muscle relaxation were satisfactory and apgar score was 10 at 1 min and 5 min in three groups. Blood gas values were within normal range in three groups. Conclusion:1% ropivacaine is effective and safe for CSEA for both parturient and neonate. The recovery from motor block is faster with ropivacaine than that with bupivacaine.
