Comparative analysis of low-dose bupivacaine and ropivacaine combined with spinal-epidural anesthesia in cesarean sections for pregnant women with coexisting mental illness.

Objective: To analyze the application effects of low-dose bupivacaine and ropivacaine combined with epidural anesthesia.

Methods: The primary outcome measure was the anesthesia effect, assessed by the excellent anesthesia rate. Secondary outcomes included the occurrence of adverse reactions, blood pressure, and serum prolactin levels at different time points. The anesthesia effect, serum prolactin levels, occurrence of adverse reactions, and MAP at various time points [before anesthesia (T0), 5 min after anesthesia (T1), at the start of surgery (T2), at delivery of the fetus (T3), and at closure of the abdomen (T4)] were compared between the two groups.

Results: ① Anesthesia effect: The excellent anesthesia rate was 71.88% in the control group and 93.94% in the observation group, with a significantly higher rate in the observation group than in the control group ( = 0.017). ② Serum prolactin levels: The serum prolactin levels in both groups increased significantly after surgery compared to before surgery ( < 0.001); however, there was no statistically significant difference in serum prolactin levels between the two groups before and after surgery ( = 0.651). ③ Occurrence of adverse reactions: The occurrence rate of adverse reactions was 28.13% in the control group and 9.09% in the observation group, with a significantly lower rate in the observation group than in the control group ( = 0.048).

Conclusion: In cesarean sections for pregnant women with coexisting mental illness, low-dose ropivacaine demonstrates significantly better anesthesia efficacy, blood pressure stability, and anesthesia safety compared to low-dose bupivacaine. Both low-dose bupivacaine and ropivacaine result in increased prolactin levels postpartum.