Olapour Alireza, Akhondzadeh Reza, Rashidi Mahbobe, Gousheh Mohammadreza, Homayoon Raziyeh
Department of Anesthesiology, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Anesth Pain Med. 2020 Jan 18;10(1):e94155. doi: 10.5812/aapm.94155. eCollection 2020 Feb.
Spinal anesthesia is the most common technique used for cesarean delivery due to some advantages compared to regional anesthesia. It is easily performed and provides a rapid onset of block. Though bupivacaine is a generally used long-acting amide type local anesthetic drug for spinal anesthesia, ropivacaine may sometimes be selected.
This prospective, randomized, double-blinded study was aimed at comparing clinical efficacy and safety between ropivacaine and bupivacaine during cesarean section.
After getting ethical committee approval and written informed consent, 65 women who referred to Imam Khomeini Hospital of Ahvaz, Iran in 2018 were chosen for elective cesarean delivery under spinal anesthesia. They were randomly allocated to receive either ropivacaine 1% (n = 33) or bupivacaine 0.5% (n = 32). Afterwards, the differences in the anesthetic efficacy, vital signs, and hemodynamics of participants between the two groups were recorded.
Duration of sensory block was shorter in the ropivacaine group than bupivacaine group (132.5 ± 21.6 min vs. 175.8 ± 26.2 min; P < 0.001). Ropivacaine also produced a shorter duration of motor blockade than bupivacaine (124.8 ± 20.2 min vs. 168.2 ± 21.7 min; P < 0.001). There is no difference between the two groups in terms of systolic and diastolic blood pressure, but the heart rate of patients in the bupivacaine group is significantly higher than the ropivacaine group.
The results suggest that ropivacaine and bupivacaine are two efficient drugs in anesthesia in the cesarean section, ropivacaine is a better choice due to little influence on the hemodynamics and shorter duration of sensory block and motor block which are useful for the recovery and also safe to the patients.
由于与区域麻醉相比具有一些优势，脊髓麻醉是剖宫产最常用的技术。它操作简便，起效迅速。虽然布比卡因是脊髓麻醉中常用的长效酰胺类局部麻醉药，但有时也会选用罗哌卡因。
这项前瞻性、随机、双盲研究旨在比较剖宫产期间罗哌卡因和布比卡因的临床疗效和安全性。
在获得伦理委员会批准并获得书面知情同意后，2018年转诊至伊朗阿瓦士伊玛目霍梅尼医院的65名妇女被选为脊髓麻醉下择期剖宫产。她们被随机分配接受1%罗哌卡因（n = 33）或0.5%布比卡因（n = 32）。之后，记录两组参与者的麻醉效果、生命体征和血流动力学差异。
罗哌卡因组的感觉阻滞持续时间短于布比卡因组（132.5±21.6分钟对175.8±26.2分钟；P<0.001）。罗哌卡因产生的运动阻滞持续时间也短于布比卡因（124.8±20.2分钟对168.2±21.7分钟；P<0.001）。两组在收缩压和舒张压方面无差异，但布比卡因组患者的心率明显高于罗哌卡因组。
结果表明，罗哌卡因和布比卡因是剖宫产麻醉中的两种有效药物，罗哌卡因是更好的选择，因为它对血流动力学影响小，感觉阻滞和运动阻滞持续时间短，这有利于恢复，对患者也安全。
