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在剖腹产时,外周用罗皮瓦卡因与布皮瓦卡因对比:系统综述和元分析

Tao Kang¹, Jiwei Tao¹, Xuetao Wang¹

¹Department of Neurosurgery, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, China.

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

|February 11, 2024

概括

罗皮瓦卡因和布皮瓦卡因在剖腹产外围麻醉中表现出类似的疗效. 罗皮瓦卡因提供更快的感觉阻断发作和减少恶心,在孕产妇或新生儿的结果没有显著差异.

科学领域:

麻醉学麻醉学
产科产科产科产科产科
药理学药理学是指药理学的学科.

背景情况:

在剖腹产时,在罗皮瓦卡因和布皮瓦卡因之间进行外周麻醉的选择仍然是有争议的,因为人们对麻醉效果和并发症的看法不同.
现有的研究提出了关于剖腹产最佳麻醉剂的相互矛盾的数据.

研究的目的:

系统地审查和比较 epidural ropivacaine 与 bupivacaine 在选择性剖腹产的疗效.
调查和分析每个麻醉剂的相关孕产妇和新生儿并发症.

主要方法:

在多个数据库进行了全面的文献搜索,包括PubMed,MEDLINE,Embase,Cochrane Library,Science-Direct和Google Scholar,截至2023年6月30日.
包括随机对照试验 (RCT),比较选择性剖腹产时的外周罗皮瓦卡因和布皮瓦卡因,主要结果是外周麻醉的成功率.

主要成果:

对8项涉及532名分娩者的RCT的分析表明,0.75%的罗皮瓦卡因与0.5%的布皮瓦卡因相比,提供了显著更短的感官阻塞发作时间.
与0.5%的布皮瓦卡因相比,0.5%的罗皮瓦卡因与母亲恶心的发病率降低有关.
两组之间没有观察到明显的差异,包括外周麻醉的成功率,孕产妇的副作用 (低血压,心肌梗塞,) 或新生儿的结果 (Apgar分数,动脉pH).

结论:

除外注射的罗皮瓦卡因和布皮瓦卡因在选择性剖腹产中显示出相似的成功率和安全性.
罗皮瓦卡因可能在更快的感觉阻断开始和减少孕产妇恶心方面提供优势.
这些发现支持使用罗皮瓦卡因或布皮瓦卡因,特定度可能会影响发病时间和恶心发生率.

关键词:

脊柱外注脊柱外注脊柱外注这是一个很好的选择. bupivacaineineine.剖腹产是一个剖腹产.这是一个元分析.罗皮瓦卡因 (ropivacaine) 是一种可怕的药物.

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