布比卡因蛛网膜下腔阻滞不同给药方式对瘢痕子宫剖宫产术产妇麻醉的效果分析

目的探究布比卡因蛛网膜下腔阻滞不同给药方式对瘢痕子宫剖宫产术产妇麻醉的效果。方法选取2018年1月至2020年2月于本院行剖宫产术分娩的瘢痕子宫产妇102例,根据给药方式的不同分为对照组和观察组,各51例,两组均行布比卡因蛛网膜下腔阻滞麻醉。对照组实施单项注射,观察组实施双向注射,比较两组手术不同时间段血流动力学指标、手术指标、新生儿娩出后的Apgar评分及麻醉不良反应发生率。结果麻醉前、麻醉后即刻、麻醉后5 min、麻醉后15 min、手术结束,两组HR、MAP、SpO;比较差异无统计学意义;观察组手术时间短于对照组,差异有统计学意义(P<0.05);两组术中出血量、平均补液量、新生儿娩出后的Apgar评分比较差异无统计学意义;观察组不良反应发生率为3.92%,低于对照组的19.61%,差异有统计学意义(P<0.05)。结论与单向注射相比,瘢痕子宫产妇实施剖宫产术分娩时行双向注射给药麻醉效果更佳,不良反应更少,手术效果更好,值得临床推广应用。

Analysis of the effect of different administration methods of bupivacaine subarachnoid block on the anesthesia of parturients undergoing cesarean section with scarred uterus

Objective To explore the effect of different administration methods of bupivacaine subarachnoid block on the anesthesia of parturients undergoing cesarean section with scarred uterus. Methods 102 women with scarred uterus who underwent cesarean section in our hospital from January 2018 to February 2020 were selected. They were divided into control group and observation group, with 51 cases in each group. Both groups underwent subarachnoid block anesthesia with bupivacaine. The control group was given single injection and the observation group was given two-way injection. The hemodynamic indexes, surgical indexes, Apgar scores and anesthesia after delivery of the newborn at different time periods of operation and the incidence of adverse reactions were compared between the two group. Results Before anesthesia, immediately after anesthesia,5 minutes after anesthesia, 15 minutes after anesthesia, and after the operation, there was no significant difference in HR, MAP, SpO;between the two groups;the operation time of the observation group was shorter than that of the control group, and the difference was statistically significant(P<0.05);there was no statistically significant difference in the amount of intraoperative blood loss, average fluid supplementation, and Apgar score after delivery of the newborn between the two groups;the incidence of adverse reactions in the observation group was 3.92%, which was lower than 19.61% in the control group, the difference was statistically significant(P<0.05). Conclusion When women with scarred uterus undergo cesarean section for delivery, compared with single injection, two-way injection has better anesthesia effect and less adverse reactions, the operation effect is better, and it is worthy of clinical application.