Clinical efficacy of three methods for assisting epidural anesthesia in puerperants undergoing repeat cesarean section
Objective To compare the clinical efficacy of three methods for assisting epidural anesthesia in the puerperants undergoing repeat cesarean section.Methods A total of 90 puerperants undergoing repeat cesarean section under epidural anesthesia were randomly divided into three groups with 30 cases each.Epidural block was performed with epidural injection of 0.75％ropivacaine in a total dose of 15 mL.Epidural block in group D was assisted by dexmedetomidine 0.5 μg/kg intravenously injected within 10 minute before surgery,which was followed by intravenous infusion of dexmedetomidine at a rate of 0.4 μg·kg-1·h-1.Epidural block in group R was assisted by intravenous infussion of remifentanil at a rate of 0.05 μg·kg-1·min-1.Epidural block in group S was assisted by sufentanil 10 μg,which was added into 15 mL of 0.75％ropivacaine for epidural block.During surgery,the infusion rate in groups of D and R was adjusted based on the VAS pain score and respiratory rate.The onset time of epidural block,the highest block plane,duration of sensory block and consumption of ropivacaine were recorded.The VAS pain score and Ramsay sedation score at 30 minutes of surgery were evaluated.pH value of umbilical vein blood after birth and Apgar scores at 1-minute and 5-minute after birth were recorded.The case number needed neonatal resuscitation after birth was also recorded.The comfort score was evaluated at the end of surgery.The adverse reactions were observed.Results Compared with group D and group R,the consumption of ropivacaine and onset time of epidural anesthesia were significantly reduced,and the duration of sensory block was prolonged in group S(P＜0.05).The consumption of ropivacaine in group R was less than that in group D(P＜0.05).The comfort score in group R was higher than that in group D and group S(P＜0.05).Compared with group D,the VAS pain scores in group R and group S were significantly lower(P＜0.05).The incidence of bradycardia in group D was higher than that in group R and group S(P＜0.05).The incidences of hypotension and pruritus in group S were higher than those in group D and group R(P＜0.05).Conclusion Intravenous infusion of remifentanil for assisting epidural anesthesia can improve the efficacy of epidural anesthesia and maternal comfort without adverse effect on maternity and neonate in the puerperants undergoing repeat cesarean section.
万方数据
维普
