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| Comparison of anesthetic effects of ropivacaine with different concentrations in gynecological surgery |
| Meishan Maternal and Child health Hospital, Sichuan Province, 620500 |
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Abstract To analyze the anesthetic effect and safety of ropivacaine in the same dose and different concentration in gynecological surgery. Methods: From February 2017 to February 2018, 63 patients undergoing gynecologic surgery were randomly divided into 3 groups: ropivacaine 0.50% group (n=21), ropivacaine 0.75% group (n=21), ropivacaine 1.00% group (n=21) according to the evaluationⅠ-Ⅱ level by the American Society of Anesthesia (SAS). The onset time of sensory analgesia, the level of sensory block, the onset and duration of motor block, the changes of mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO2) of patients were compared among the three groups. Results: There were no significant different in the onset time of sensory analgesia, the level of sensory block, the duration of analgesia and the duration of motor block among the three groups (P>0.05). Bromage score of patients in 0.50% group was significant higher than that of patients in 0.75% group and 1.00% group (P<0.05). The standard time of motor block of patients in 0.5% group was significant longer than that of patients in 0.75% group and 1.00% group (P<0.05). There was no significant difference in the effect of epidural anesthesia between 0.75% group and 1.00% group (P>0.05) The dosage of PCEA analgesic drugs used in 0.50% group had significant different (P<0.05), the dosage of ketamine, 0.2% ropivacaine, and morphine used in 1.00% group was the lowest. There was no significant difference in the changes of MAP, HR, and SpO2 among the three groups at the time point of T1, T2, T3 and T4 (P>0.05). Conclusion: 0.50%, 0.75% or 1.00% ropivacaine all can be used in gynecological operation, which has good level of sensory block and lasting effect. The relaxation of abdominal wall muscle and the analgesic effect of postoperative analgesia when 0.5% ropivacaine used are less than those of 1.00% ropivacaine used. The effect of muscle relaxation and analgesia is perfect when 1.00% ropivacaine used, but it is necessary to consider the risk of nerve injury. So 0.75% ropivacaine used is the best, which can meet the needs of gynecological surgery, and can reduce the potential complication risk of high concentration ropivacaine.
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