Effect of ropivacaine concentrations in combined spinalepidural anesthesia on efficacy and sedation levels in lower abdominal obesity patients

Abstract

Purpose: To investigate the effect of varying ropivacaine concentrations in combined spinal-epidural anesthesia (CSEA) on anesthetic  efficacy and sedation in patients with lower abdominal obesity. Methods: 110 patients with lower abdominal obesity who received CSEA  in Traditional Chinese Medicine Hospital, Lin 'an District, Hangzhou, China from January 2020 to December 2022 were retrospectively  enrolled. Patients were divided into a low-concentration group (LC group, n = 49) which received 0.3 % ropivacaine, and a high- concentration group (HC group, n = 61) which received 0.5 % ropivacaine. Changes in visual analogue scale (VAS) scores and Ramsay  sedation scale (RSS) scores in both groups were analyzed at 1, 2, 4 and 6 h after surgery. Results: The LC group showed significantly  higher static and dynamic VAS scores than HC group at 1, 2, 4 and 6 h after surgery. Furthermore, HC group demonstrated significantly  shorter (p < 0.05) onset times for sensory and motor blocks, longer sensory and motor recovery times, and lower mean arterial pressure  (MAP) level 10 min after administration compared to the LC group. However, MAP levels 30 min after administration were similar to  baseline levels in both groups (p > 0.05). Conclusion: High-concentration ropivacaine in CSEA offers superior post-operative analgesia,  and improves patient satisfaction without increasing adverse reactions in patients with lower abdominal obesity. Further studies using  larger sample size and longer duration of investigation are required to strengthen the validity of these results.