静脉滴注麻黄素预防剖腹产腰麻后低血压的临床研究

目的:研究在麻醉前静脉滴注小剂量麻黄素预防剖腹产腰麻后低血压。方法:选择在腰麻-硬膜外麻醉联合麻醉下行剖宫产的产妇60例,ASAⅠ级~Ⅱ级,随机分成两组:观察组(Ⅰ组)、对照组(Ⅱ组)每组30例。Ⅰ组麻醉前开放静脉通路,麻黄素10mg加入500ml平衡液中静脉滴注,Ⅱ组仅用平衡液静脉滴注,按10ml/kg于25min~30min内进行扩容。记录两组产妇麻醉前(T0)、麻醉后5min(T1)、麻醉后10min(T2)、麻醉后20min(T3)和麻醉后30min(T4)各时点的SBP和HR的变化,以及低血压、恶心、呕吐等并发症的发生情况,记录胎儿出生后的Apgar评分。结果:与T0时比较,Ⅰ组T1~T2时SBP下降(P<0.05),Ⅱ组T1~T3时SBP均下降,其中T1~T2时差异有显著性(P<0.01),T3时差异有显著性(P<0.05);与Ⅰ组比较,T1~T3时Ⅱ组SBP下降明显(P<0.05);两组麻醉后HR均有所增快,与T0相比差异无显著性,两组之间比较亦差异无显著性;两组低血压和恶心、呕吐的发生率两组相比差异有显著性(P<0.05),新生儿Apgar评分两组差异无显著性。结论:麻醉前预先静脉滴注麻黄素10mg能够预防剖腹产腰麻后低血压的发生,减少恶心、呕吐和心动过缓等并发症。

Preventive Effect of Ephedrine on Hypotension In Caesarean Section Patients

Objective To observe the effect ofephedrine ,for prevention ofhypotension in caesarean section patients. Methods 60 ASAⅠ～Ⅱ patientsundergoing caesarean section with spinal-epidural anesthesia, were randomly divided into two groups with 30 cases each: observation group(groupⅠ) and control group(group Ⅱ). 10 mg of ephedrine for group Ⅰ and 1 ml of normal saline for groupⅡ were ad ministered before anesthesia was given by intravenous drip. The systolic blood pressure(SBP) , heart rate(HR) , nausea and vomiting rate, Apgar score were recorded after anesthesia. Results SBP decreased significantly at T_1 and T_2 in group Ⅰ(P<0.05), SBP also decreased in group Ⅱ,there are very significantly difference at T_1 and T_2 (P<0.01),and significantly difference at T_3 compare with those at T_0;Compared with groupⅠ, SBP decreased significantly at T_1 ,T_2 and T_3 in groupⅡ(P<0.05);HR increased after anesthesia in two groups, but the change was not remarkable compare with T_0, and there were no significantly difference between two groups;The hypotension nausea and vomiting rate was significantly lower in group Ⅰ compare with in group Ⅱ(P<0.05), Apgar score were not significant different(P>0.05). Conclusion 10 mg of ephedrine given by intravenous drip before anesthesia, can preventhypotension in caesarean section patients, the bradycardia nausea and vomiting rate were also significantly lower.