腰硬联合麻醉与硬膜外阻滞麻醉在急诊剖宫产术中的应用效果比较

目的探讨硬膜外阻滞麻醉(EA)与腰硬联合麻醉(CSEA)在急诊剖宫产术中的安全性及治疗效果。方法选取我院2011年2月至2012年6月急诊收治的剖宫产患者80例,按随机性原则分为CSEA组40例和EA组40例,比较两组患者的不良反应发生情况及新生儿Apgar评分、下肢运动阻滞效果、胎儿娩出时间、手术时间、麻醉起效时间。结果 CSEA组胎儿娩出时间、手术时间、麻醉起效时间明显优于EA组,两组比较差异有统计学意义(P<0.01);两组患者不良反应发生情况差异不显著,无统计学意义。结论 CSEA应用于急诊剖宫产术中具有阻滞完善、用药少、起效快,对呼吸、循环系统的影响较EA少,术后可连接镇痛泵等优点,值得临床进一步推广应用。

Effect Comparison of Combined Spinal and Epidural Anesthesia and Epidural Block Anesthesia in Application of Emergency Cesarean Section

Objective To discuss the safety and treatment effect of epidural block anesthesia（EA） and combined spinal and epidural anesthesia（CSEA） in application of emergency cesarean section.Method 80 cases of emergency cesarean section patients in our hospital from 2011.2 to 2012.6 were chosen and divided randomly into CSEA group and EA group both with 40 cases.Patients of the two groups were compared in occurrence of adverse reactions,newborn babies’ Apgar scores,lower limb movement block effect,time of delivery,time of operation and onset time of anesthesia.Result The time of delivery and operation and the onset time of anesthesia of CSEA group was obviously better than CA group and the difference was statistically significant（P0.05）;There was no significant difference between the two groups in occurrence of adverse reaction.Conclusion The application of CSEA in emergency cesarean section has the advantage of complete block,fewer drugs,quicker onset and fewer effects on respiratory and circulatory systems than EA and it can connect to analgesia pump after operation.It’s worthy of further promotion in clinical work.