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Abstract To compare the anesthetic effect of ropivacaine and bupivacaine used during the pregnancy termination surgery of pregnant women with cardiovascular diseases. Methods: 120 pregnant women with cardiovascular diseases who wanted pregnancy termination surgery were included in this study from January 2019 to January 2021. According to the admission time, these women were randomly divided into two groups (60 cases in each group). The women in the control group were given bupivacaine for anesthetic during surgery and the women in the observation group were given ropivacaine for anesthetic during surgery. The anesthetic effect, the difficulty of cervical dilatation, the degree of lower abdominal pain and Bromage score at 30 minutes after surgery, the perioperative bleeding volume, the vital signs, and the levels of myocardial enzyme spectrum, such as lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme MB (CK-MB), and aspartate aminotransferase (AST), the brain natriuretic peptide (BNP) level, the electrocardiogram result, and the adverse reactions rate of the women were compared between the two groups. Results: There were no significant differences in the cervical dilation, the anesthesia effect, and the postoperative pain degree of the women between the two groups (P＞0.05). After operation, the rates of Bromage scores of grade 0, grade I, grade II, and grade III of the women in the control group in the observation group were 11.1%, 46.0%, 34.9%, and 3.2%, respectively, and which of the women in the observation group were 63.5%, 30.2%, 1.6%, and 0, respectively. The grade 0 and grade I of the women in the observation group were significantly better than those of the women in the control group (P<0.05). There were no significant differences in the amount of blood loss, the operation time, and the time from drug withdrawal to awakening of the women between the two groups (P＞0.05). The time of discharge from hospital of the women in the observation group was significantly less than that of the women in the control group (P<0.05). There were no significant differences in the values of perioperative blood pressure, heart rate, and oxygen saturation of finger pulse of the women between the two groups (P＞0.05). The levels of LDH, CK, CK-MB, AST, and BNP of the women in the observation group were significantly lower than those of the women in the control group (P<0.05). There was no significant difference in the abnormal rate of perioperative ECG of the women between the two groups (P＞0.05). The rate of perioperative adverse reactions (6.7%) of the women in the observation group was significantly lower than that (17.1%) of the women in the control group (P<0.05). Conclusion: Ropivacaine and bupivacaine used during the pregnancy termination surgery of the pregnant women with cardiovascular diseases had the same anesthetic effect, but ropivacaine has less impact on the myocardial enzymes and BNP of the patients， fewer adverse reactions, and faster postoperative recovery.
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