The Clinical Observation Of Ropivacaine With Different Concentrations In Lumbar Anesthesia For Cesarean Section

ObjectiveThe subjects for cesarean section, the proportion of CSEA in the subarachnoid injection of different concentrations of ropivacaine to observe the reaction of hemodynamic changes in maternal, neonatal and maternal postoperative feeling、motor block recovery time. Intended to find a more suitable dose of ropivacaine.MethodsAll the pregnant women are from the maternity of Yanbian university affiliated hospital.200cases of full-term preanancy elective cesarean section maternal (ASA I), weight55-80kg, height153-168cm, age22-33years old. All the cases were randomly divided into four groups (A, B, C, D), each group with50cases. Group A:Ropivacaine10mg, Group B:Ropivacaine9mg, Croup C:Ropivacaine8mg, Group D:Ropivacaine7mg. To puncture between three and four lumbar, use the cerebrospinal fluid dilute1%ropivacaine into0.5%,0.45%,0.4%,0.35%, and the total volume is2ml, and the injection speed are all lml/5s.The hemodynamic changes of all cases were observing. The SBP、DBP、 HR、CI、CO、SV and SVR were recorded before anesthesia (T0),1min after anesthesia (T1),3min (T2), cut skin (T3), delivery of the baby(T4),3min after delivery of the baby (T5),5min after delivery of the baby (T6), leave the operating room(T7). Record the time of cutting skin, sensory block plane and Bromage score with the time of cutting skin and leave operating room, the duration of the movement block and sensory block plane. Record the Apgar score, the use and times of ephedrine dosage, and the satisfaction rate of anaesthetic effect. Recording the occurrence of urinary retention, headache, neurological syndrome and other compli-cations after operation.Result1. The comparision of hemodynamic:The influence on hemodynamics in group A, B were bigger than group C (P <0.05). There was no significant difference in group A, B (P>0.05) and in group C, D (P>0.05).2. The comparision of sensory block plane, Bromage Score,the sensory block plane and Bromage Score leave the room, the duration of the movement block and sensory block:(1) There was no significant difference among group A, B, C and D with sensory block plane after anesthesia (P>0.05). The sensory block plane leave the room in group A, B were higher than group C, D(P<0.05).(2)The Bromage Score after anesthesia in group A was higher than group B, C, D (P<0.05); The Bromage Score leave the room in group A, B were higher than group C, D(P<0.05).(3) The duration of the movement block in group A, B were longer than group C, D(P<0.05), group D was shorter than group C(P<0.05). The duration of sensory block in group A, B were longer than group C, D(P<0.05), group D was shorter than group C(P<0.05).3. The comparision of Apgar score and the satisfaction of anaesthetic effect:(1) Apgar score:There was no difference in all the cases.(2) Group D was lower than GroupA, B, C in the satisfaction of anaesthetic effect (P<0.05).4. The comparision of dosage of ephedrine:GroupA, B were higher than GroupC(P<0.05).5. The comparision of adverse reactions: GroupA, B were higher than GroupC with nausea symptoms. Group D was higher than other groups with referred pain.6. There was no urinary retention, headache, neurological syndrome and other complications after operation.ConclusionThe low concentration of0.40%ropivacaine8mg is the best dose and concentration in cesarean section of CSEA, and it should be highly popularized.