ABSTRACT
Background:
Ropivacaine (Ropi) is a widely utilized
anesthetic in
cesarean sections (CS), however its optimal
dosage remains controversial.
Objective:
To assess the
efficacy and
safety of varying doses (10mg, 5mg, 4mg, and 3mg) of Ropi in subarachnoid block (SA) for CS.
Methods:
A prospective
cohort study was conducted, and a total of 74
pregnant women undergoing CS at Nantong
Maternal and Child Health Care
Hospital between January and June 2023 were selected as the study
population. Participants were stratified into groups based on
Ropivacaine dosage Group A (10 mg, n=18), Group B (5 mg, n=26), Group C (4 mg, n=15), and Group D (3 mg, n=15). The total
Ropivacaine dosage administered via SA was consistently 10 mg across all groups. We measured
anesthetic efficacy,
safety profiles,
abdominal wall muscle relaxation, pre- and post-
anesthesia stress and inflammatory responses before and after
anesthesia and compared among the four groups.
Results:
Group A exhibited the shortest onset
time for block initiation and longest recovery duration (P < .05). Group D displayed the highest
incidence of
patients requiring additional
anesthetics and experiencing adverse reactions, whereas the utilization rate of vasopressors was most pronounced in Group A (P < .05). Notably, Group D reported the lowest
satisfaction rate regarding
abdominal wall muscle relaxation (P < .05). Stress responses were significantly lower in Groups A, B, and C compared to Group D, while the levels of inflammatory factors in Groups B and C were higher than those in Group A but lower than those in Group D (P < .05).
Conclusions:
Administration of 4 mg hyperbaric Ropi in SA can achieve an optimal
anesthesia effect in CS with a high level of
safety, along with inducing mild
abdominal wall muscle relaxation and attenuating stress and inflammatory responses pre- and post-
anesthesia. Thus, it is recommended for clinical application.