Comparison Of Ropivacaine At Different Concentrations For Postoperative Analgesia In Cesarean Section

Objective:To observe whether epidural analgesia with different volumes of ropivacaine used in cesarean section has differences in analgesic effect,motor nerve block,and adverse reactions.Methods:From December 2017 to March 2018,120 cases of full-term cesarean delivery for emergency cesarean section were selected at the Fourth Affiliated Hospital of Kunming Medical University.ASA grade Ⅰ-Ⅱ grade,no contraindications for spinal anesthesia,voluntary Postoperative epidural analgesia is required.Randomly divided into A,B,C three groups,each group of 40 cases,all the postpartum patients were given loading dose of 5mg and the continuous infusion rate is 5mg.h-1,the bolus is 2.5mg/order.However,because the electronic driving device of the injection pump can only be accurate to one decimal place,group A is divided into two subgroups,Aiand A2.Each group has 20 cases with a concentration of 0.08%.Group Ai,the loading dose is 6.3ml,the continuous infusion rate is 6.3ml.h-1,the bolus is 3.1ml/order.Group A2,the loading dose is 6.2ml,the continuous infusion rate is 6.2ml.h-1,the bolus is 3.1ml/order.Group B,the concentration is 0.1%,the loading dose is 5ml,the continuous infusion rate is 5ml.h-1,the bolus is 2.5ml/order.Group C,the concentration is 0.125%,the loading dose is 4ml,the continuous infusion rate is 4ml.h-1,the bolus is 2ml/order,patient-controlled interval was 20 min in four groups.and observe the static VAS score,dynamic VAS score,Bromage score,the number of effective presses of PCA and adverse reactions in the four groups at 6h,12h,24h,36h,48 hours after cesarean section.All the mothers chose a combined lumbar-abdominal block,and the anesthetist connected the epidural analgesia pump when the peritoneum was started be closed and gave the corresponding loading dose and continuous infusion rate according to the enrollment status.Results:Because of epidural catheter fall off,catheter blockage and maternal requirements to end the analgesia and some other reasons to exclude 6 cases,the actual number is 114 cases.There was no significant difference in age,height,weight,operation time,ASA grades and Proportion of primipara and parturients among the four groups(P>0.05).There is no statistical difference in A1 and A2 groups at Dynamic VAS score,static VAS score and Bromage score within 48 hours after operation(P>0.05).Within 36 hours after operation,the dynamic VAS scores,static VAS scores,and the number of effective presses of PC A in the A1 and A2 groups were significantly lower than those in the C group(P<0.05).From the 36th to 48th hours after surgery,A1,A2,and C There was no significant difference in the above three groups(P>0.05).The first exhaust time of A1 and A2 was significantly shorter than that of group C(P<0.05).During the whole observation period,there was no significant difference in dynamic VAS score,static VAS score,Bromage score,and exhaust time between group B and A1,A2 and C.There was no significant difference in the bromage scores of the four groups A1,A2,B,and C within 48 hours after operation(P>0.05).Conclusions:After cesarean section,5mg.h-1 ropivacaine was administered for postoperative analgesia after epidural cesarean section,and the0.08%group was superior to the 0.1%group and 0.125%group in terms of analgesic effect,intestinal exhalation time.